Machine Tool Advanced Skills Technology (MAST). Common Ground: Toward a Standards-Based Training System for the U.S. Machine Tool and Metal Related Industries. Volume 3: Machining, of a 15-Volume Set of Skill Standards and Curriculum Training Materials for the Precision Manufacturing Industry.

ERIC Educational Resources Information Center

Texas State Technical Coll., Waco.

This document is intended to help education and training institutions deliver the Machine Tool Advanced Skills Technology (MAST) curriculum to a variety of individuals and organizations. MAST consists of industry-specific skill standards and model curricula for 15 occupational specialty areas within the U.S. machine tool and metals-related…

Introducing a feedback training system for guided home rehabilitation.

PubMed

Kohler, Fabian; Schmitz-Rode, Thomas; Disselhorst-Klug, Catherine

2010-01-15

As the number of people requiring orthopaedic intervention is growing, individualized physiotherapeutic rehabilitation and adequate postoperative care becomes increasingly relevant. The chances of improvement in the patients condition is directly related to the performance and consistency of the physiotherapeutic exercises.In this paper a smart, cost-effective and easy to use Feedback Training System for home rehabilitation based on standard resistive elements is introduced. This ensures high accuracy of the exercises performed and offers guidance and control to the patient by offering direct feedback about the performance of the movements.46 patients were recruited and performed standard physiotherapeutic training to evaluate the system. The results show a significant increase in the patient's ability to reproduce even simple physiotherapeutic exercises when being supported by the Feedback Training System. Thus physiotherapeutic training can be extended into the home environment whilst ensuring a high quality of training.

49 CFR 236.901 - Purpose and scope.

Code of Federal Regulations, 2010 CFR

2010-10-01

... control systems, subsystems, and components that are safety-critical products, as defined in § 236.903..., MAINTENANCE, AND REPAIR OF SIGNAL AND TRAIN CONTROL SYSTEMS, DEVICES, AND APPLIANCES Standards for Processor-Based Signal and Train Control Systems § 236.901 Purpose and scope. (a) What is the purpose of this...

Development of a computer-based training (CBT) course for the FSUTMS comprehensive modeling workshop.

DOT National Transportation Integrated Search

2008-09-01

FSUTMS training is a major activity of the Systems Planning Office of the Florida Department of : Transportation (FDOT). The training aims to establish and maintain quality assurance for consistent : statewide modeling standards and provide up-to-dat...

The educational environment for training in intensive care medicine: structures, processes, outcomes and challenges in the European region.

PubMed

2009-09-01

To characterise the training environment in ICM across Europe, with a particular focus on factors influencing competency-based training. A cross-sectional web-based survey completed by the national coordinator for the CoBaTrICE (Competency-Based Training in Intensive Care medicinE) programme in each of 28 European countries. Since the last survey in 2004, 50% of EU countries have modified their training programmes. Seven have already adopted the CoBaTrICE programme since its completion in 2006. Multidisciplinary access to ICM training ('supraspeciality' model) is available in 57%, most commonly as a 2-year training programme. National examinations are held by 26 (93%); in 24 (86%) this is a mandatory exit exam; ten use the European Diploma of Intensive Care (EDIC). A formal national system for quality assurance of ICM training exists in only 18 (64%) countries. National standards for approving hospitals as training centres vary widely. In 29% there is no designated specialist with responsibility for training at the local level. Time for teaching was cited as inadequate by 93% of respondents; only 21% of trainers receive contractual recognition for their work. In 39% there is no protected teaching time for trainees. Half of countries surveyed have no formal system for workplace-based assessment of competence of trainees. There is considerable diversity in pedagogic structures, processes and quality assurance of ICM across Europe. National training organisations should develop common standards for quality assurance, health systems need to invest in educator support, and the EU should facilitate harmonisation by recognising ICM as a multidisciplinary speciality.

Machine Tool Advanced Skills Technology (MAST). Common Ground: Toward a Standards-Based Training System for the U.S. Machine Tool and Metal Related Industries. Volume 9: Tool and Die, of a 15-Volume Set of Skill Standards and Curriculum Training Materials for the Precision Manufacturing Industry.

ERIC Educational Resources Information Center

Texas State Technical Coll., Waco.

This document is intended to help education and training institutions deliver the Machine Tool Advanced Skills Technology (MAST) curriculum to a variety of individuals and organizations. MAST consists of industry-specific skill standards and model curricula for 15 occupational specialty areas within the U.S. machine tool and metals-related…

Machine Tool Advanced Skills Technology (MAST). Common Ground: Toward a Standards-Based Training System for the U.S. Machine Tool and Metal Related Industries. Volume 8: Sheet Metal & Composites, of a 15-Volume Set of Skill Standards and Curriculum Training Materials for the Precision Manufacturing Industry.

ERIC Educational Resources Information Center

Texas State Technical Coll., Waco.

This document is intended to help education and training institutions deliver the Machine Tool Advanced Skills Technology (MAST) curriculum to a variety of individuals and organizations. MAST consists of industry-specific skill standards and model curricula for 15 occupational specialty areas within the U.S. machine tool and metals-related…

Machine Tool Advanced Skills Technology (MAST). Common Ground: Toward a Standards-Based Training System for the U.S. Machine Tool and Metal Related Industries. Volume 4: Manufacturing Engineering Technology, of a 15-Volume Set of Skill Standards and Curriculum Training Materials for the Precision Manufacturing Industry.

ERIC Educational Resources Information Center

Texas State Technical Coll., Waco.

This document is intended to help education and training institutions deliver the Machine Tool Advanced Skills Technology (MAST) curriculum to a variety of individuals and organizations. MAST consists of industry-specific skill standards and model curricula for 15 occupational specialty areas within the U.S. machine tool and metals-related…

Machine Tool Advanced Skills Technology (MAST). Common Ground: Toward a Standards-Based Training System for the U.S. Machine Tool and Metal Related Industries. Volume 14: Automated Equipment Technician (CIM), of a 15-Volume Set of Skill Standards and Curriculum Training Materials for the Precision Manufacturing Industry.

ERIC Educational Resources Information Center

Texas State Technical Coll., Waco.

This document is intended to help education and training institutions deliver the Machine Tool Advanced Skills Technology (MAST) curriculum to a variety of individuals and organizations. MAST consists of industry-specific skill standards and model curricula for 15 occupational specialty areas within the U.S. machine tool and metals-related…

Machine Tool Advanced Skills Technology (MAST). Common Ground: Toward a Standards-Based Training System for the U.S. Machine Tool and Metal Related Industries. Volume 10: Computer-Aided Drafting & Design, of a 15-Volume Set of Skill Standards and Curriculum Training Materials for the Precision Manufacturing Industry.

ERIC Educational Resources Information Center

Texas State Technical Coll., Waco.

This document is intended to help education and training institutions deliver the Machine Tool Advanced Skills Technology (MAST) curriculum to a variety of individuals and organizations. MAST consists of industry-specific skill standards and model curricula for 15 occupational specialty areas within the U.S. machine tool and metals-related…

Machine Tool Advanced Skills Technology (MAST). Common Ground: Toward a Standards-Based Training System for the U.S. Machine Tool and Metal Related Industries. Volume 11: Computer-Aided Manufacturing & Advanced CNC, of a 15-Volume Set of Skill Standards and Curriculum Training Materials for the Precision Manufacturing Industry.

ERIC Educational Resources Information Center

Texas State Technical Coll., Waco.

This document is intended to help education and training institutions deliver the Machine Tool Advanced Skills Technology (MAST) curriculum to a variety of individuals and organizations. MAST consists of industry-specific skill standards and model curricula for 15 occupational specialty areas within the U.S. machine tool and metals-related…

Machine Tool Advanced Skills Technology (MAST). Common Ground: Toward a Standards-Based Training System for the U.S. Machine Tool and Metal Related Industries. Volume 2: Career Development, General Education and Remediation, of a 15-Volume Set of Skill Standards and Curriculum Training Materials for the Precision Manufacturing Industry.

ERIC Educational Resources Information Center

Texas State Technical Coll., Waco.

This document is intended to help education and training institutions deliver the Machine Tool Advanced Skills Technology (MAST) curriculum to a variety of individuals and organizations. MAST consists of industry-specific skill standards and model curricula for 15 occupational specialty areas within the U.S. machine tool and metals-related…

Machine Tool Advanced Skills Technology (MAST). Common Ground: Toward a Standards-Based Training System for the U.S. Machine Tool and Metal Related Industries. Volume 7: Industrial Maintenance Technology, of a 15-Volume Set of Skill Standards and Curriculum Training Materials for the Precision Manufacturing Industry.

ERIC Educational Resources Information Center

Texas State Technical Coll., Waco.

This document is intended to help education and training institutions deliver the Machine Tool Advanced Skills Technology (MAST) curriculum to a variety of individuals and organizations. MAST consists of industry-specific skill standards and model curricula for 15 occupational specialty areas within the U.S. machine tool and metals-related…

49 CFR 236.923 - Task analysis and basic requirements.

Code of Federal Regulations, 2013 CFR

2013-10-01

..., INSPECTION, MAINTENANCE, AND REPAIR OF SIGNAL AND TRAIN CONTROL SYSTEMS, DEVICES, AND APPLIANCES Standards for Processor-Based Signal and Train Control Systems § 236.923 Task analysis and basic requirements..., inspection, testing, and operating tasks that must be performed on a railroad's products. This includes the...

49 CFR 236.923 - Task analysis and basic requirements.

Code of Federal Regulations, 2014 CFR

2014-10-01

..., INSPECTION, MAINTENANCE, AND REPAIR OF SIGNAL AND TRAIN CONTROL SYSTEMS, DEVICES, AND APPLIANCES Standards for Processor-Based Signal and Train Control Systems § 236.923 Task analysis and basic requirements..., inspection, testing, and operating tasks that must be performed on a railroad's products. This includes the...

49 CFR 236.923 - Task analysis and basic requirements.

Code of Federal Regulations, 2010 CFR

2010-10-01

..., INSPECTION, MAINTENANCE, AND REPAIR OF SIGNAL AND TRAIN CONTROL SYSTEMS, DEVICES, AND APPLIANCES Standards for Processor-Based Signal and Train Control Systems § 236.923 Task analysis and basic requirements..., inspection, testing, and operating tasks that must be performed on a railroad's products. This includes the...

49 CFR 236.923 - Task analysis and basic requirements.

Code of Federal Regulations, 2012 CFR

2012-10-01

..., INSPECTION, MAINTENANCE, AND REPAIR OF SIGNAL AND TRAIN CONTROL SYSTEMS, DEVICES, AND APPLIANCES Standards for Processor-Based Signal and Train Control Systems § 236.923 Task analysis and basic requirements..., inspection, testing, and operating tasks that must be performed on a railroad's products. This includes the...

United States Air Force Unmanned Aircraft Systems Flight Plan 2009-2047

DTIC Science & Technology

2009-05-18

future challenges facing the USAF and the Joint Force through 2047. Michael B. Donley Secretary of the Air Force - 3 - AJI ¥-Jcf2c .~~~ Norton A...is depicted along a DOTMLPF-P stratified timeline as a colored triangle. Red triangles represent actions that require senior leader involvement to...Flag, and Red Flag. Joint UAS training may lead to greater training efficiencies and standardization. Training standards may be applied based on the

The development of an assessment system for dental vocational training and general professional training: a Scottish approach.

PubMed

Prescott, L E; McKinlay, P; Rennie, J S

2001-01-13

The role of competencies in postgraduate dental education and training has been a major topic of interest in recent years. Concerns have been voiced from all sides of the profession about how the competence of trainees and the quality of training can be assured so that high standards of patient care can be maintained. A three year project which seeks to develop a competency-based assessment system for general professional training is underway which hopes to answer some of the concerns and provide an evidence-based system of assessment for the early postgraduate years. This paper looks at the reasoning behind the project, its aims, and the progress made to date.

Health Technology Integration for Clinical, Patient Records and Financial Management Related to the Military

DTIC Science & Technology

2012-09-01

approaches for nurses regarding the usage of a newly-implemented electronic health records (EHR) system at a large hospital. The study compares the...standard classroom training had no measureable effect on training outcomes. Our second key finding is that nurses with higher levels of education and...Staff Training, Nurse Training, Web-Based Training, EHR Training, Health Information Technology, HIT Health Technology Integration for Clinical

Adult Bronchoscopy Training

PubMed Central

Wahidi, Momen M.; Read, Charles A.; Buckley, John D.; Addrizzo-Harris, Doreen J.; Shah, Pallav L.; Herth, Felix J. F.; de Hoyos Parra, Alberto; Ornelas, Joseph; Yarmus, Lonny; Silvestri, Gerard A.

2015-01-01

BACKGROUND: The determination of competency of trainees in programs performing bronchoscopy is quite variable. Some programs provide didactic lectures with hands-on supervision, other programs incorporate advanced simulation centers, whereas others have a checklist approach. Although no single method has been proven best, the variability alone suggests that outcomes are variable. Program directors and certifying bodies need guidance to create standards for training programs. Little well-developed literature on the topic exists. METHODS: To provide credible and trustworthy guidance, rigorous methodology has been applied to create this bronchoscopy consensus training statement. All panelists were vetted and approved by the CHEST Guidelines Oversight Committee. Each topic group drafted questions in a PICO (population, intervention, comparator, outcome) format. MEDLINE data through PubMed and the Cochrane Library were systematically searched. Manual searches also supplemented the searches. All gathered references were screened for consideration based on inclusion criteria, and all statements were designated as an Ungraded Consensus-Based Statement. RESULTS: We suggest that professional societies move from a volume-based certification system to skill acquisition and knowledge-based competency assessment for trainees. Bronchoscopy training programs should incorporate multiple tools, including simulation. We suggest that ongoing quality and process improvement systems be introduced and that certifying agencies move from a volume-based certification system to skill acquisition and knowledge-based competency assessment for trainees. We also suggest that assessment of skill maintenance and improvement in practice be evaluated regularly with ongoing quality and process improvement systems after initial skill acquisition. CONCLUSIONS: The current methods used for bronchoscopy competency in training programs are variable. We suggest that professional societies and certifying agencies move from a volume- based certification system to a standardized skill acquisition and knowledge-based competency assessment for pulmonary and thoracic surgery trainees. PMID:25674901

75 FR 72664 - System Personnel Training Reliability Standards

Federal Register 2010, 2011, 2012, 2013, 2014

2010-11-26

...Under section 215 of the Federal Power Act, the Commission approves two Personnel Performance, Training and Qualifications (PER) Reliability Standards, PER-004-2 (Reliability Coordination--Staffing) and PER-005-1 (System Personnel Training), submitted to the Commission for approval by the North American Electric Reliability Corporation, the Electric Reliability Organization certified by the Commission. The approved Reliability Standards require reliability coordinators, balancing authorities, and transmission operators to establish a training program for their system operators, verify each of their system operators' capability to perform tasks, and provide emergency operations training to every system operator. The Commission also approves NERC's proposal to retire two existing PER Reliability Standards that are replaced by the standards approved in this Final Rule.

Use of WONCA global standards to evaluate family medicine postgraduate education for curriculum development and review in Nepal and Myanmar.

PubMed

Gibson, Christine; Ladak, Farah; Shrestha, Ashis; Yadav, Bharat; Thu, Kyaw; Aye, Tin

2016-09-01

Family medicine is an integral part of primary care within health systems. Globally, training programmes exhibit a great degree of variability in content and skill acquisition. While this may in part reflect the needs of a given setting, there exists standard criteria that all family medicine programmes should consider core activities. WONCA has provided an open-access list of standards that their expert community considers essential for family medicine (GP) post-graduate training. Evaluation of developing or existing training programmes using these standards can provide insight into the degree of variability, gaps within programmes and equally as important, gaps within recommendations. In collaboration with the host institution, two family medicine programmes in Nepal and Myanmar were evaluated based on WONCA global standards. The results of the evaluation demonstrated that such a process can allow for critical review of curriculum in various stages of development and evaluation. The implications of reviewing training programmes according to WONCA standards can lead to enhanced training world-wide and standardisation of training for post-graduate family medicine.

Factors Affecting Success of Training Companies

ERIC Educational Resources Information Center

Rogala, Piotr; Batko, Roman; Wawak, Slawomir

2017-01-01

This study aims to identify the key factors which influence the functioning quality and success of training companies. Based on an analysis of the requirements included in the quality management system standards for providers of education and training services, a set of twenty factors has been developed. This was followed by a survey for…

Comparative hazard evaluation of near-infrared diode lasers.

PubMed

Marshall, W J

1994-05-01

Hazard evaluation methods from various laser protection standards differ when applied to extended-source, near-infrared lasers. By way of example, various hazard analyses are applied to laser training systems, which incorporate diode lasers, specifically those that assist in training military or law enforcement personnel in the proper use of weapons by simulating actual firing by the substitution of a beam of near-infrared energy for bullets. A correct hazard evaluation of these lasers is necessary since simulators are designed to be directed toward personnel during normal use. The differences among laser standards are most apparent when determining the hazard class of a laser. Hazard classification is based on a comparison of the potential exposures with the maximum permissible exposures in the 1986 and 1993 versions of the American National Standard for the Safe Use of Lasers, Z136.1, and the accessible emission limits of the federal laser product performance standard. Necessary safety design features of a particular system depend on the hazard class. The ANSI Z136.1-1993 standard provides a simpler and more accurate hazard assessment of low-power, near-infrared, diode laser systems than the 1986 ANSI standard. Although a specific system is evaluated, the techniques described can be readily applied to other near-infrared lasers or laser training systems.

Implementation Plan for Worldwide Airborne Command Post (WWABNCP) Operator Computer-Based Training (PLATO): Decision Paper.

DTIC Science & Technology

1985-10-03

Electrospace Systems, Inc. (ESI). ESI con- ducted a market search for training systems that would enhance unit level training, minimize cost-prohibitive...can be reprogrammed to simulate the UGC -129 keyboard. This keyboard is the standard keyboard used for data transmission on board the EC-135 and E-4B...with the appropriate technical order, and the functions and operation of the AN/ UGC -129 (ASR) terminals used with the AN/ASC-21 AFSATCOM system. In

Machine Tool Advanced Skills Technology (MAST). Common Ground: Toward a Standards-Based Training System for the U.S. Machine Tool and Metal Related Industries. Volume 1: Executive Summary, of a 15-Volume Set of Skills Standards and Curriculum Training Materials for the Precision Manufacturing Industry.

ERIC Educational Resources Information Center

Texas State Technical Coll., Waco.

The Machine Tool Advanced Skills Technology (MAST) consortium was formed to address the shortage of skilled workers for the machine tools and metals-related industries. Featuring six of the nation's leading advanced technology centers, the MAST consortium developed, tested, and disseminated industry-specific skill standards and model curricula for…

Emergency department-based interventions for women suffering domestic abuse: a critical literature review.

PubMed

Ansari, Sereena; Boyle, Adrian

2017-02-01

Domestic abuse represents a serious public health and human rights concern. Interventions to reduce the risk of abuse include staff training and standardized documentation improving detection and adherence to referral pathways. Interventional studies have been conducted in primary care, maternity and outpatient settings. Women disclosing abuse in emergency departments differ from women attending other healthcare settings, and it is unclear whether these interventions can be transferred to the emergency care setting. This review examines interventional studies to evaluate the effectiveness of emergency department-based interventions in reducing domestic abuse-related morbidity. Medline, EMBASE, CINAHL, PsycINFO and Cochrane Library were searched, according to prespecified selection criteria. Study quality was assessed using the Jadad scale. Of 273 search results, nine were eligible for review. Interventions involving staff training demonstrated benefits in subjective measures, such as staff knowledge regarding abuse, but no changes in clinical practice, based on detection and referral rates. When staff training was implemented in conjunction with supporting system changes - for example, standardized documentation for assessment and referral - clinically relevant improvements were noted. Interventions centred around staff training are insufficient to bring about improvements in the management and, thus, outcome of patients suffering abuse. Instead, system changes, such as standardized documentation and referral pathways, supported by training, may bring about beneficial changes. It remains uncertain whether surrogate outcomes employed by most studies translate to changes in abuse-related morbidity: the ultimate goal.

National Standards and Curriculum Reform: A View from the Department of Education.

ERIC Educational Resources Information Center

Ravitch, Diane

1992-01-01

Successful standards-based reform requires fundamental reconstruction of educational institutions and systems, so that high standards become the basis of curriculum, textbooks and other instructional materials, assessments, graduation requirements, and teacher education, certification, and training. A great failure of our public education system…

Fuel and Electrical Systems Mechanic. Apprenticeship Training Standards = Mecanicien de systemes d'alimentation en carburant et electriques. Normes de formation en apprentissage.

ERIC Educational Resources Information Center

Ontario Ministry of Skills Development, Toronto.

These training standards for fuel and electrical systems mechanics are intended to be used by apprentice/trainees, instructors, and companies in Ontario, Canada, as a blueprint for training or as a prerequisite for prerequisite for accreditation/certification. The training standards identify skills required for this occupation and its related…

Simulation improves procedural protocol adherence during central venous catheter placement: a randomized-controlled trial

PubMed Central

Peltan, Ithan D.; Shiga, Takashi; Gordon, James A.; Currier, Paul F.

2015-01-01

Background Simulation training may improve proficiency at and reduces complications from central venous catheter (CVC) placement, but the scope of simulation’s effect remains unclear. This randomized controlled trial evaluated the effects of a pragmatic CVC simulation program on procedural protocol adherence, technical skill, and patient outcomes. Methods Internal medicine interns were randomized to standard training for CVC insertion or standard training plus simulation-based mastery training. Standard training involved a lecture, a video-based online module, and instruction by the supervising physician during actual CVC insertions. Intervention-group subjects additionally underwent supervised training on a venous access simulator until they demonstrated procedural competence. Raters evaluated interns’ performance during internal jugular CVC placement on actual patients in the medical intensive care unit. Generalized estimating equations were used to account for outcome clustering within trainees. Results We observed 52 interns place 87 CVCs. Simulation-trained interns exhibited better adherence to prescribed procedural technique than interns who received only standard training (p=0.024). There were no significant differences detected in first-attempt or overall cannulation success rates, mean needle passes, global assessment scores or complication rates. Conclusions Simulation training added to standard training improved protocol adherence during CVC insertion by novice practitioners. This study may have been too small to detect meaningful differences in venous cannulation proficiency and other clinical outcomes, highlighting the difficulty of patient-centered simulation research in settings where poor outcomes are rare. For high-performing systems, where protocol deviations may provide an important proxy for rare procedural complications, simulation may improve CVC insertion quality and safety. PMID:26154250

Space Age Training

NASA Technical Reports Server (NTRS)

1996-01-01

Teledyne Brown developed a computer-based interactive multimedia training system for use with the Crystal Growth Furnace in the U.S. Microgravity Laboratory-2 mission on the Space Shuttle. Teledyne Brown commercialized the system and customized it for PPG Industries Aircraft Products. The system challenges learners with role-playing scenarios and software-driven simulations engaging all the senses using text, video, animation, voice, sounds and music. The transfer of this technology to commercial industrial process training has resulted in significant improvements in effectiveness, standardization, and quality control, as well as cost reductions over the usual classroom and on-the- job training approaches.

Programmatic assessment of a university-based implant training program using patient-reported outcomes.

PubMed

Al-Sabbagh, Mohanad; Jenkins, Diane W; de Leeuw, Reny; Nihill, Patricia; Robinson, Fonda G; Thomas, Mark V

2014-11-01

The University of Kentucky College of Dentistry (UKCD) established an implant training program that provides training in the use of a single implant system, evidence-based diagnostic and treatment protocols (standardized work practices), and a total quality management system (Implant Quality Assurance Program). The aim of this study was to assess the programmatic effectiveness of the UKCD implant training program by reporting the success and survival of implants placed, using patient-reported outcomes and comparing them to previously established benchmarks. A total of 415 patients (963 implants) were interviewed, approximately 50 percent of all qualified patients. The implant survival rate was 97 percent, and 88 percent of the implants were considered successful (as determined by patient-centric criteria). These outcomes were consistent with the program's previously established benchmarks of 90 percent. These results suggest that work standardization (in the form of specific treatment protocols) and the use of a formal, incremental learning system can result in positive patient outcomes. Clinical outcomes should be monitored in academic dental settings as part of clinical process improvement, and these outcomes can provide a means of assessing the effectiveness of the training program.

Development of Entry-Level Competence Tests: A Strategy for Evaluation of Vocational Education Training Systems

ERIC Educational Resources Information Center

Schutte, Marc; Spottl, Georg

2011-01-01

Developing countries such as Malaysia and Oman have recently established occupational standards based on core work processes (functional clusters of work objects, activities and performance requirements), to which competencies (performance determinants) can be linked. While the development of work-process-based occupational standards is supposed…

Downlink Training Techniques for FDD Massive MIMO Systems: Open-Loop and Closed-Loop Training With Memory

NASA Astrophysics Data System (ADS)

Choi, Junil; Love, David J.; Bidigare, Patrick

2014-10-01

The concept of deploying a large number of antennas at the base station, often called massive multiple-input multiple-output (MIMO), has drawn considerable interest because of its potential ability to revolutionize current wireless communication systems. Most literature on massive MIMO systems assumes time division duplexing (TDD), although frequency division duplexing (FDD) dominates current cellular systems. Due to the large number of transmit antennas at the base station, currently standardized approaches would require a large percentage of the precious downlink and uplink resources in FDD massive MIMO be used for training signal transmissions and channel state information (CSI) feedback. To reduce the overhead of the downlink training phase, we propose practical open-loop and closed-loop training frameworks in this paper. We assume the base station and the user share a common set of training signals in advance. In open-loop training, the base station transmits training signals in a round-robin manner, and the user successively estimates the current channel using long-term channel statistics such as temporal and spatial correlations and previous channel estimates. In closed-loop training, the user feeds back the best training signal to be sent in the future based on channel prediction and the previously received training signals. With a small amount of feedback from the user to the base station, closed-loop training offers better performance in the data communication phase, especially when the signal-to-noise ratio is low, the number of transmit antennas is large, or prior channel estimates are not accurate at the beginning of the communication setup, all of which would be mostly beneficial for massive MIMO systems.

Optimization of Simulation-Based Training Systems: Model Description, Implementation, and Evaluation

DTIC Science & Technology

1990-06-01

Taskcs01 for Instructional _______Cue ______ 0__ Fq’o~eturesResponse 1A I Analyze Tasks %Requirements 018 TaskfrFieiy0-m Learning fo ielt asl... academic instruction on aircraft systems, emergency procedures, and tactics. Although some Army aviators enter the AH-I AQC immediately after completing...from low to high fidelity, and (d) tasks could not be trained to standard using academic training only. The tasks that were chosen are enumerated in

Community-based first aid: a program report on the intersection of community-based participatory research and first aid education in a remote Canadian Aboriginal community.

PubMed

VanderBurgh, D; Jamieson, R; Beardy, J; Ritchie, S D; Orkin, A

2014-01-01

Community-based first aid training is the collaborative development of locally relevant emergency response training. The Sachigo Lake Wilderness Emergency Response Education Initiative was developed, delivered, and evaluated through two intensive 5-day first aid courses. Sachigo Lake First Nation is a remote Aboriginal community of 450 people in northern Ontario, Canada, with no local paramedical services. These courses were developed in collaboration with the community, with a goal of building community capacity to respond to medical emergencies. Most first aid training programs rely on standardized curriculum developed for urban and rural contexts with established emergency response systems. Delivering effective community-based first aid training in a remote Aboriginal community required specific adaptations to conventional first aid educational content and pedagogy. Three key lessons emerged during this program that used collaborative principles to adapt conventional first aid concepts and curriculum: (1) standardized approaches may not be relevant nor appropriate; (2) relationships between course participants and the people they help are relevant and important; (3) curriculum must be attentive to existing informal and formal emergency response systems. These lessons may be instructive for the development of other programs in similar settings.

Comparison of standard (self-directed) versus intensive patient training for the human insulin inhalation powder (HIIP) delivery system in patients with type 2 diabetes: efficacy, safety, and training measures.

PubMed

Rosenstock, Julio; Nakano, Masako; Silverman, Bernard L; Sun, Bin; de la Peña, Amparo; Suri, Ajit; Muchmore, Douglas B

2007-02-01

The Lilly/Alkermes human insulin inhalation powder (HIIP) delivery system [AIR (a registered trademark of Alkermes, Inc., Cambridge, MA) Inhaled Insulin System] was designed to be easy to use. Training methods were compared in insulin-naive patients with type 2 diabetes. Patients (n = 102) were randomized to standard or intensive training. With standard training, patients learned how to use the HIIP delivery system by reading directions for use (DFU) and trying on their own. Intensive training included orientation to the HIIP delivery system with individual coaching and inspiratory flow rate training. Both groups received preprandial HIIP + metformin with or without a thiazolidinedione for 4 weeks. Overall 2-h postprandial blood glucose (PPBG) excursion was the primary measure. Noninferiority was defined as the upper limit of the two-sided 95% confidence interval of the mean difference between groups being 1.2 < or = mmol/L. Overall 2-h PPBG excursions (least squares mean +/- SE) at endpoint were -0.11 +/- 0.38 (standard training) and 0.23 +/- 0.36 (intensive training) mmol/L. The mean difference (standard minus intensive training) and two-sided 95% confidence interval were -0.35 (-1.02, 0.33) mmol/L. No statistically or clinically significant differences were observed between training methods in premeal, postmeal, or bedtime blood glucose values, HIIP doses at endpoint, or blood glucose values after a test meal. No discontinuations occurred because of difficulty of use or dislike of the HIIP system. DFU compliance was >90% in both training groups. There were no significant differences between training methods in safety measures. The HIIP delivery system is easy to use, and most patients can learn to use it by reading the DFU without assistance from health care professionals.

Machine Tool Advanced Skills Technology (MAST). Common Ground: Toward a Standards-Based Training System for the U.S. Machine Tool and Metal Related Industries. Volume 15: Administrative Information, of a 15-Volume Set of Skill Standards and Curriculum Training Materials for the Precision Manufacturing Industry.

ERIC Educational Resources Information Center

Texas State Technical Coll., Waco.

This volume developed by the Machine Tool Advanced Skill Technology (MAST) program contains key administrative documents and provides additional sources for machine tool and precision manufacturing information and important points of contact in the industry. The document contains the following sections: a foreword; grant award letter; timeline for…

14 CFR Appendix E to Part 60 - Qualification Performance Standards for Quality Management Systems for Flight Simulation Training...

Code of Federal Regulations, 2010 CFR

2010-01-01

... Quality Management Systems for Flight Simulation Training Devices E Appendix E to Part 60 Aeronautics and Space FEDERAL AVIATION ADMINISTRATION, DEPARTMENT OF TRANSPORTATION (CONTINUED) AIRMEN FLIGHT SIMULATION...—Qualification Performance Standards for Quality Management Systems for Flight Simulation Training Devices Begin...

Toward a Naval Aviation Training Quality Feedback System

ERIC Educational Resources Information Center

Phillips, Henry L., IV; Foster, T. Chris

2008-01-01

Naval aviation needs a unified standard for job-task analyses and data collection. Such a standard would facilitate consolidation of data across aviation platforms and permit evaluation of training content across phases of the training continuum. It would also make possible the construction of a training transfer evaluation system. The Navy cannot…

Virtual reality: emerging role of simulation training in vascular access.

PubMed

Davidson, Ingemar J A; Lok, Charmaine; Dolmatch, Bart; Gallieni, Maurizio; Nolen, Billy; Pittiruti, Mauro; Ross, John; Slakey, Douglas

2012-11-01

Evolving new technologies in vascular access mandate increased attention to patient safety; an often overlooked yet valuable training tool is simulation. For the end-stage renal disease patient, simulation tools are effective for all aspects of creating access for peritoneal dialysis and hemodialysis. Based on aviation principles, known as crew resource management, we place equal emphasis on team training as individual training to improve interactions between team members and systems, cumulating in improved safety. Simulation allows for environmental control and standardized procedures, letting the trainee practice and correct mistakes without harm to patients, compared with traditional patient-based training. Vascular access simulators range from suture devices, to pressurized tunneled conduits for needle cannulation, to computer-based interventional simulators. Simulation training includes simulated case learning, root cause analysis of adverse outcomes, and continual update and refinement of concepts. Implementation of effective human to complex systems interaction in end-stage renal disease patients involves a change in institutional culture. Three concepts discussed in this article are as follows: (1) the need for user-friendly systems and technology to enhance performance, (2) the necessity for members to both train and work together as a team, and (3) the team assigned to use the system must test and practice it to a proficient level before safely using the system on patients. Copyright © 2012 Elsevier Inc. All rights reserved.

Family-based training program improves brain function, cognition, and behavior in lower socioeconomic status preschoolers

PubMed Central

Neville, Helen J.; Stevens, Courtney; Pakulak, Eric; Bell, Theodore A.; Fanning, Jessica; Klein, Scott; Isbell, Elif

2013-01-01

Using information from research on the neuroplasticity of selective attention and on the central role of successful parenting in child development, we developed and rigorously assessed a family-based training program designed to improve brain systems for selective attention in preschool children. One hundred forty-one lower socioeconomic status preschoolers enrolled in a Head Start program were randomly assigned to the training program, Head Start alone, or an active control group. Electrophysiological measures of children’s brain functions supporting selective attention, standardized measures of cognition, and parent-reported child behaviors all favored children in the treatment program relative to both control groups. Positive changes were also observed in the parents themselves. Effect sizes ranged from one-quarter to half of a standard deviation. These results lend impetus to the further development and broader implementation of evidence-based education programs that target at-risk families. PMID:23818591

Evidence for electronic health record systems in physical therapy.

PubMed

Vreeman, Daniel J; Taggard, Samuel L; Rhine, Michael D; Worrell, Teddy W

2006-03-01

With increasing pressures to better manage clinical information, we investigated the role of electronic health record (EHR) systems in physical therapist practice through a critical review of the literature. We reviewed studies that met our predefined criteria after independent review by 3 authors. The investigators in all of the reviewed studies reported benefits, including improved reporting, operational efficiency, interdepartmental communication, data accuracy, and capability for future research. In 7 studies, the investigators reported barriers, including challenges with behavior modification, equipment inadequacy, and training. The investigators in all studies reported key success factors, including end-user participation, adequate training, workflow analysis, and data standardization. This review suggests that EHRs have potential benefits for physical therapists. The authors formed the following recommendations based on the studies' themes: (1) incorporate workflow analysis into system design and implementation; (2) include end users, especially clinicians, in system development; (3) devote significant resources for training; (4) plan and test carefully to ensure adequate software and hardware performance; and (5) commit to data standards.

Development of use of an Operational Procedure Information System (OPIS) for future space missions

NASA Technical Reports Server (NTRS)

Illmer, N.; Mies, L.; Schoen, A.; Jain, A.

1994-01-01

A MS-Windows based electronic procedure system, called OPIS (Operational Procedure Information System), was developed. The system consists of two parts, the editor, for 'writing' the procedure and the notepad application, for the usage of the procedures by the crew during training and flight. The system is based on standardized, structured procedure format and language. It allows the embedding of sketches, photos, animated graphics and video sequences and the access to off-nominal procedures by linkage to an appropriate database. The system facilitates the work with procedures of different degrees of detail, depending on the training status of the crew. The development of a 'language module' for the automatic translation of the procedures, for example into Russian, is planned.

Challenges in Developing Competency-based Training Curriculum for Food Safety Regulators in India.

PubMed

Thippaiah, Anitha; Allagh, Komal Preet; Murthy, G V

2014-07-01

The Food Safety and Standards Act have redefined the roles and responsibilities of food regulatory workforce and calls for highly skilled human resources as it involves complex management procedures. 1) Identify the competencies needed among the food regulatory workforce in India. 2) Develop a competency-based training curriculum for food safety regulators in the country. 3) Develop training materials for use to train the food regulatory workforce. The Indian Institute of Public Health, Hyderabad, led the development of training curriculum on food safety with technical assistance from the Royal Society for Public Health, UK and the National Institute of Nutrition, India. The exercise was to facilitate the implementation of new Act by undertaking capacity building through a comprehensive training program. A competency-based training needs assessment was conducted before undertaking the development of the training materials. THE TRAINING PROGRAM FOR FOOD SAFETY OFFICERS WAS DESIGNED TO COMPRISE OF FIVE MODULES TO INCLUDE: Food science and technology, Food safety management systems, Food safety legislation, Enforcement of food safety regulations, and Administrative functions. Each module has a facilitator guide for the tutor and a handbook for the participant. Essentials of Food Hygiene-I (Basic level), II and III (Retail/ Catering/ Manufacturing) were primarily designed for training of food handlers and are part of essential reading for food safety regulators. The Food Safety and Standards Act calls for highly skilled human resources as it involves complex management procedures. Despite having developed a comprehensive competency-based training curriculum by joint efforts by the local, national, and international agencies, implementation remains a challenge in resource-limited setting.

Virtual operating room for team training in surgery.

PubMed

Abelson, Jonathan S; Silverman, Elliott; Banfelder, Jason; Naides, Alexandra; Costa, Ricardo; Dakin, Gregory

2015-09-01

We proposed to develop a novel virtual reality (VR) team training system. The objective of this study was to determine the feasibility of creating a VR operating room to simulate a surgical crisis scenario and evaluate the simulator for construct and face validity. We modified ICE STORM (Integrated Clinical Environment; Systems, Training, Operations, Research, Methods), a VR-based system capable of modeling a variety of health care personnel and environments. ICE STORM was used to simulate a standardized surgical crisis scenario, whereby participants needed to correct 4 elements responsible for loss of laparoscopic visualization. The construct and face validity of the environment were measured. Thirty-three participants completed the VR simulation. Attendings completed the simulation in less time than trainees (271 vs 201 seconds, P = .032). Participants felt the training environment was realistic and had a favorable impression of the simulation. All participants felt the workload of the simulation was low. Creation of a VR-based operating room for team training in surgery is feasible and can afford a realistic team training environment. Copyright © 2015 Elsevier Inc. All rights reserved.

Boosting drug named entity recognition using an aggregate classifier.

PubMed

Korkontzelos, Ioannis; Piliouras, Dimitrios; Dowsey, Andrew W; Ananiadou, Sophia

2015-10-01

Drug named entity recognition (NER) is a critical step for complex biomedical NLP tasks such as the extraction of pharmacogenomic, pharmacodynamic and pharmacokinetic parameters. Large quantities of high quality training data are almost always a prerequisite for employing supervised machine-learning techniques to achieve high classification performance. However, the human labour needed to produce and maintain such resources is a significant limitation. In this study, we improve the performance of drug NER without relying exclusively on manual annotations. We perform drug NER using either a small gold-standard corpus (120 abstracts) or no corpus at all. In our approach, we develop a voting system to combine a number of heterogeneous models, based on dictionary knowledge, gold-standard corpora and silver annotations, to enhance performance. To improve recall, we employed genetic programming to evolve 11 regular-expression patterns that capture common drug suffixes and used them as an extra means for recognition. Our approach uses a dictionary of drug names, i.e. DrugBank, a small manually annotated corpus, i.e. the pharmacokinetic corpus, and a part of the UKPMC database, as raw biomedical text. Gold-standard and silver annotated data are used to train maximum entropy and multinomial logistic regression classifiers. Aggregating drug NER methods, based on gold-standard annotations, dictionary knowledge and patterns, improved the performance on models trained on gold-standard annotations, only, achieving a maximum F-score of 95%. In addition, combining models trained on silver annotations, dictionary knowledge and patterns are shown to achieve comparable performance to models trained exclusively on gold-standard data. The main reason appears to be the morphological similarities shared among drug names. We conclude that gold-standard data are not a hard requirement for drug NER. Combining heterogeneous models build on dictionary knowledge can achieve similar or comparable classification performance with that of the best performing model trained on gold-standard annotations. Copyright © 2015 The Authors. Published by Elsevier B.V. All rights reserved.

Current Challenges and Future Opportunities for Child and Adolescent Psychiatry in Japan

PubMed Central

Inagaki, Takahiko; Saito, Takuya; Guerrero, Anthony P. S.; Skokauskas, Norbert

2017-01-01

Japan has been facing a serious shortfall of child and adolescent psychiatric workforce relative to increasing service needs. Likely because of a combination of limited workforce supply and limited trust or perception of effectiveness, mental health services are under-utilized by the educational and child welfare systems. Child and adolescent psychiatry (CAP) has not been a formally established specialty in Japan. The lack of basic structure in the specialty most likely contributes to a lack of training facilities, limited exposure to and interest in the specialty, and hence an inadequate workforce. To date, there exists no standardized training program for CAP in Japan and each training hospital determines its own teaching curriculum and training content. Clinical experience in CAP varies greatly among hospitals. To solve current problems in child and adolescent psychiatry in Japan, we advocate for the development and establishment of a more standardized child and adolescent psychiatry training system that is akin to what exists in the US and that teaches and evaluates according to specific competencies. Through standardizing care and education and ultimately improving workforce, the quality of mental health services can be raised. The tragic and costly consequences of unidentified and untreated mental illness in youth can be avoided by taking timely evidence based actions in partnership with others. PMID:29042875

Meta-learning framework applied in bioinformatics inference system design.

PubMed

Arredondo, Tomás; Ormazábal, Wladimir

2015-01-01

This paper describes a meta-learner inference system development framework which is applied and tested in the implementation of bioinformatic inference systems. These inference systems are used for the systematic classification of the best candidates for inclusion in bacterial metabolic pathway maps. This meta-learner-based approach utilises a workflow where the user provides feedback with final classification decisions which are stored in conjunction with analysed genetic sequences for periodic inference system training. The inference systems were trained and tested with three different data sets related to the bacterial degradation of aromatic compounds. The analysis of the meta-learner-based framework involved contrasting several different optimisation methods with various different parameters. The obtained inference systems were also contrasted with other standard classification methods with accurate prediction capabilities observed.

Implementation and evaluation of a tele-education system for the diagnosis of ophthalmic disease by international trainees

PubMed Central

Campbell, J. Peter; Swan, Ryan; Jonas, Karyn; Ostmo, Susan; Ventura, Camila V.; Martinez-Castellanos, Maria A.; Anzures, Rachelle Go Ang Sam; Chiang, Michael F.; Chan, R.V. Paul

2015-01-01

Tele-education systems are increasingly being utilized in medical education worldwide. Due to limited human resources in healthcare in low and middle-income countries, developing online systems that are accessible to medical trainees in underserved areas potentially represents a highly efficient and effective method of improving the quantity and quality of the health care workforce. We developed, implemented, and evaluated an interactive web-based tele-education system (based on internationally accepted, image-based guidelines) for the diagnosis of retinopathy of prematurity among ophthalmologists-in-training in Brazil, Mexico, and the Philippines. We demonstrate that participation in this tele-education program improved diagnostic accuracy and reliability, and was preferred to standard pedagogical methods. This system may be employed not only in training, but also in international certification programs, and the process may be generalizable to other image-based specialties, such as dermatology and radiology. PMID:26958168

Implementation and evaluation of a tele-education system for the diagnosis of ophthalmic disease by international trainees.

PubMed

Campbell, J Peter; Swan, Ryan; Jonas, Karyn; Ostmo, Susan; Ventura, Camila V; Martinez-Castellanos, Maria A; Anzures, Rachelle Go Ang Sam; Chiang, Michael F; Chan, R V Paul

Tele-education systems are increasingly being utilized in medical education worldwide. Due to limited human resources in healthcare in low and middle-income countries, developing online systems that are accessible to medical trainees in underserved areas potentially represents a highly efficient and effective method of improving the quantity and quality of the health care workforce. We developed, implemented, and evaluated an interactive web-based tele-education system (based on internationally accepted, image-based guidelines) for the diagnosis of retinopathy of prematurity among ophthalmologists-in-training in Brazil, Mexico, and the Philippines. We demonstrate that participation in this tele-education program improved diagnostic accuracy and reliability, and was preferred to standard pedagogical methods. This system may be employed not only in training, but also in international certification programs, and the process may be generalizable to other image-based specialties, such as dermatology and radiology.

Experimental study of a fuel cell power train for road transport application

NASA Astrophysics Data System (ADS)

Corbo, P.; Corcione, F. E.; Migliardini, F.; Veneri, O.

The development of fuel cell electric vehicles requires the on-board integration of fuel cell systems and electric energy storage devices, with an appropriate energy management system. The optimization of performance and efficiency needs an experimental analysis of the power train, which has to be effected in both stationary and transient conditions (including standard driving cycles). In this paper experimental results concerning the performance of a fuel cell power train are reported and discussed. In particular characterization results for a small sized fuel cell system (FCS), based on a 2.5 kW PEM stack, alone and coupled to an electric propulsion chain of 3.7 kW are presented and discussed. The control unit of the FCS allowed the main stack operative parameters (stoichiometric ratio, hydrogen and air pressure, temperature) to be varied and regulated in order to obtain optimized polarization and efficiency curves. Experimental runs effected on the power train during standard driving cycles have allowed the performance and efficiency of the individual components (fuel cell stack and auxiliaries, dc-dc converter, traction batteries, electric engine) to be evaluated, evidencing the role of output current and voltage of the dc-dc converter in directing the energy flows within the propulsion system.

Online self-administered training for post-traumatic stress disorder treatment providers: design and methods for a randomized, prospective intervention study

PubMed Central

2012-01-01

This paper presents the rationale and methods for a randomized controlled evaluation of web-based training in motivational interviewing, goal setting, and behavioral task assignment. Web-based training may be a practical and cost-effective way to address the need for large-scale mental health training in evidence-based practice; however, there is a dearth of well-controlled outcome studies of these approaches. For the current trial, 168 mental health providers treating post-traumatic stress disorder (PTSD) were assigned to web-based training plus supervision, web-based training, or training-as-usual (control). A novel standardized patient (SP) assessment was developed and implemented for objective measurement of changes in clinical skills, while on-line self-report measures were used for assessing changes in knowledge, perceived self-efficacy, and practice related to cognitive behavioral therapy (CBT) techniques. Eligible participants were all actively involved in mental health treatment of veterans with PTSD. Study methodology illustrates ways of developing training content, recruiting participants, and assessing knowledge, perceived self-efficacy, and competency-based outcomes, and demonstrates the feasibility of conducting prospective studies of training efficacy or effectiveness in large healthcare systems. PMID:22583520

[2018 National consensus on cardiopulmonary resuscitation training in China].

PubMed

Wang, Lixiang; Meng, Qingyi; Yu, Tao

2018-05-01

To promote the technical training and scientific popularization of cardiopulmonary resuscitation (CPR) in China, the Cardiopulmonary Resuscitation Specialized Committee of Chinese Research Hospital Association combined with the Science Popularization Branch of the Chinese Medical Association wrote "2018 National consensus on cardiopulmonary resuscitation training in China". The formation was based on the general outline about "2016 National consensus on cardiopulmonary resuscitation in China", and to implement the important strategies included the "three pre" policy, prevention, precognition, and pre-warning, before the cardiac arrest (CA); the "three modernization" methods, standardized, diversified and individualized, during the CA; and the "three life" strategies, the rebirth, the extra and the extended, after the CA; and also combined with the concrete National conditions and clinical practice of China area. The document summarized the evidence of published science about CPR training till now, and recommend the establishment of "the CPR Training Triangle" according to the Chinese National conditions. The bases of the triangle were system, training and person, the core of which was CPR science. The main contents were: (1) The "three training" policy for CPR training: the cultivation of a sound system, which included professional credibility, extensive mobilization and continuous driving force, and the participation of the whole people and continuous improvement; the cultivation of scientific guidelines, which included scientific content, methods and thinking; and the cultivation of a healthy culture, which included the enhancement of civic quality, education of rescue scientifically, and advocate of healthy life. (2) The "three training" program of CPR training: training professional skills, which included standard, multiple, and individual skills; training multidimensional, which included time, space, and human; and training flexible, including problem, time, and innovation oriented. (3) The "three party" direction of CPR training, the application for achievement translation, which included scientific translations, skill propagators, and cultural advocates; the precision disseminators, which included accurate communication sources, channels, and dissemination of the audience; and theoretical innovation guides, which included scientific, popular science and communication theory. That integrated the wisdom of scholars, melt the thought of genius, and created the act of envoy for Chinese and foreign CPR training. The training program should be suitable for different trainee, no matter who is trainer or trainee. The release of the expert consensus on the 2018 CPR training will make the National CPR education into the new training era with definite direction, clear target and fully standard of China.

The CREST Simulation Development Process: Training the Next Generation.

PubMed

Sweet, Robert M

2017-04-01

The challenges of training and assessing endourologic skill have driven the development of new training systems. The Center for Research in Education and Simulation Technologies (CREST) has developed a team and a methodology to facilitate this development process. Backwards design principles were applied. A panel of experts first defined desired clinical and educational outcomes. Outcomes were subsequently linked to learning objectives. Gross task deconstruction was performed, and the primary domain was classified as primarily involving decision-making, psychomotor skill, or communication. A more detailed cognitive task analysis was performed to elicit and prioritize relevant anatomy/tissues, metrics, and errors. Reference anatomy was created using a digital anatomist and clinician working off of a clinical data set. Three dimensional printing can facilitate this process. When possible, synthetic or virtual tissue behavior and textures were recreated using data derived from human tissue. Embedded sensors/markers and/or computer-based systems were used to facilitate the collection of objective metrics. A learning Verification and validation occurred throughout the engineering development process. Nine endourology-relevant training systems were created by CREST with this approach. Systems include basic laparoscopic skills (BLUS), vesicourethral anastomosis, pyeloplasty, cystoscopic procedures, stent placement, rigid and flexible ureteroscopy, GreenLight PVP (GL Sim), Percutaneous access with C-arm (CAT), Nephrolithotomy (NLM), and a vascular injury model. Mixed modalities have been used, including "smart" physical models, virtual reality, augmented reality, and video. Substantial validity evidence for training and assessment has been collected on systems. An open source manikin-based modular platform is under development by CREST with the Department of Defense that will unify these and other commercial task trainers through the common physiology engine, learning management system, standard data connectors, and standards. Using the CREST process has and will ensure that the systems we create meet the needs of training and assessing endourologic skills.

Report of the first annual airborne weapons training technology review

DOE Office of Scientific and Technical Information (OSTI.GOV)

Snyder, C.E.; Payne, G.B.; Treitler, I.E.

1990-01-01

This report documents the First Annual Airborne Weapons Training Technology Review. The Review was held at Oak Ridge Associated Universities from March 29 to 31, 1989. It was an exchange of ideas and information among the members of the network supporting the Naval Air Systems Command's (NAVAIR's) PMA205-11, Program Manager for Ordnance Training. This report describes the briefings and demonstrations presented at the Review, and summarizes the discussion at the informal caucus where significant issues were raised from the first two days' presentations. The report also contains the meeting agenda, a participant list with addresses and telephone numbers, a listmore » of the Department of Defense activities represented, NAVAIR's follow-up communication, and a brief description of Martin Marietta Energy Systems, Inc.'s training technology project support. A broad range of topics related to training systems and training support was covered during the Review. Synopses of the presentations and demonstrations included here cover computer-based and interactive systems, portability of software, reuse of training systems for different weapons, standardization of trainers, instructional systems design, cognitive task analysis, tracking of training resources, and the application of Computer-aided Acquisition and Logistic Support.« less

Use of Low-Fidelity Simulation Laboratory Training for Teaching Radiology Residents CT-Guided Procedures.

PubMed

Picard, Melissa; Nelson, Rachel; Roebel, John; Collins, Heather; Anderson, M Bret

2016-11-01

To determine the benefit of the addition of low-fidelity simulation-based training to the standard didactic-based training in teaching radiology residents common CT-guided procedures. This was a prospective study involving 24 radiology residents across all years in a university program. All residents underwent standard didactic lecture followed by low-fidelity simulation-based training on three common CT-guided procedures: random liver biopsy, lung nodule biopsy, and drain placement. Baseline knowledge, confidence, and performance assessments were obtained after the didactic session and before the simulation training session. Approximately 2 months later, all residents participated in a simulation-based training session covering all three of these procedures. Knowledge, confidence, and performance data were obtained afterward. These assessments covered topics related to preprocedure workup, intraprocedure steps, and postprocedure management. Knowledge data were collected based on a 15-question assessment. Confidence data were obtained based on a 5-point Likert-like scale. Performance data were obtained based on successful completion of predefined critical steps. There was significant improvement in knowledge (P = .005), confidence (P < .008), and tested performance (P < .043) after the addition of simulation-based training to the standard didactic curriculum for all procedures. This study suggests that the addition of low-fidelity simulation-based training to a standard didactic-based curriculum is beneficial in improving resident knowledge, confidence, and tested performance of common CT-guided procedures. Copyright © 2016 American College of Radiology. Published by Elsevier Inc. All rights reserved.

Challenges in Developing Competency-based Training Curriculum for Food Safety Regulators in India

PubMed Central

Thippaiah, Anitha; Allagh, Komal Preet; Murthy, G. V.

2014-01-01

Context: The Food Safety and Standards Act have redefined the roles and responsibilities of food regulatory workforce and calls for highly skilled human resources as it involves complex management procedures. Aims: 1) Identify the competencies needed among the food regulatory workforce in India. 2) Develop a competency-based training curriculum for food safety regulators in the country. 3) Develop training materials for use to train the food regulatory workforce. Settings and Design: The Indian Institute of Public Health, Hyderabad, led the development of training curriculum on food safety with technical assistance from the Royal Society for Public Health, UK and the National Institute of Nutrition, India. The exercise was to facilitate the implementation of new Act by undertaking capacity building through a comprehensive training program. Materials and Methods: A competency-based training needs assessment was conducted before undertaking the development of the training materials. Results: The training program for Food Safety Officers was designed to comprise of five modules to include: Food science and technology, Food safety management systems, Food safety legislation, Enforcement of food safety regulations, and Administrative functions. Each module has a facilitator guide for the tutor and a handbook for the participant. Essentials of Food Hygiene-I (Basic level), II and III (Retail/ Catering/ Manufacturing) were primarily designed for training of food handlers and are part of essential reading for food safety regulators. Conclusion: The Food Safety and Standards Act calls for highly skilled human resources as it involves complex management procedures. Despite having developed a comprehensive competency-based training curriculum by joint efforts by the local, national, and international agencies, implementation remains a challenge in resource-limited setting. PMID:25136155

AVETMISS: The Standard for VET Financial Data. Release 1.7. Updated

ERIC Educational Resources Information Center

National Centre for Vocational Education Research (NCVER), 2009

2009-01-01

The Standard for Vocational Education and Training (VET) financial data offers a nationally consistent standard for the collection, reporting and analysis of the public vocational education and training system information throughout Australia. It forms part of the Australian Vocational Education and Training Management Information Statistical…

75 FR 54223 - Petition for Waiver of Compliance

Federal Register 2010, 2011, 2012, 2013, 2014

2010-09-03

... requirements of 49 CFR Part 232--Brake System Safety Standards for Freight and Other Non-Passenger Trains and Equipment; End-of Train Devices, CFR Part 229--Railroad Locomotive Safety Standards, and CFR Part 215--Railroad Freight Car Safety Standards. Specifically, UP seeks relief to permit trains received at the U.S...

49 CFR 236.504 - Operation interconnected with automatic block-signal system.

Code of Federal Regulations, 2011 CFR

2011-10-01

... GOVERNING THE INSTALLATION, INSPECTION, MAINTENANCE, AND REPAIR OF SIGNAL AND TRAIN CONTROL SYSTEMS, DEVICES, AND APPLIANCES Automatic Train Stop, Train Control and Cab Signal Systems Standards § 236.504... or train control system shall operate in connection with an automatic block signal system and shall...

Modern "Challenges" in the System of Personnel Training: Standardization and Innovations

ERIC Educational Resources Information Center

Zaitseva, Natalia; Dzhandzhugazova, Elena; Bondarchuk, Natalya; Zhukova, Marina

2017-01-01

Purpose: The study of the problems hindering improvement of the system of training through standardization of qualification requirements is relevant because, in a globalized system of teaching staff and high rates of migration, not only national but also international requirements for employees should be considered. This increases the…

Tailoring a training based on the Mental Health Gap Action Programme (mhGAP) Intervention Guide (IG) to Tunisia: process and relevant adaptations.

PubMed

Spagnolo, Jessica; Champagne, François; Leduc, Nicole; Melki, Wahid; Guesmi, Imen; Bram, Nesrine; Guisset, Ann-Lise; Piat, Myra; Laporta, Marc; Charfi, Fatma

2018-01-01

In order to make mental health services more accessible, the Tunisian Ministry of Health, in collaboration with the School of Public Health at the University of Montreal, the World Health Organization office in Tunisia and the Montreal World Health Organization-Pan American Health Organization Collaborating Center for Research and Training in Mental Health, implemented a training programme based on the Mental Health Gap Action Programme (mhGAP) Intervention Guide (IG) (version 1.0) , developed by the World Health Organization. This article describes the phase prior to the implementation of the training, which was offered to general practitioners working in primary care settings in the Greater Tunis area of Tunisia. The phase prior to implementation consisted of adapting the standard mhGAP-IG (version 1.0) to the local primary healthcare context. This adaptation process, an essential step before piloting the training, involved discussions with stakeholder groups, as well as field observations. Through the adaptation process, we were able to make changes to the standard training format and material. In addition, the process helped uncover systemic barriers to effective mental health care. Targeting these barriers in addition to implementing a training programme may help reduce the mental health treatment gap, and promote implementation that is successful and sustainable.

[Remote intelligent Brunnstrom assessment system for upper limb rehabilitation for post-stroke based on extreme learning machine].

PubMed

Wang, Yue; Yu, Lei; Fu, Jianming; Fang, Qiang

2014-04-01

In order to realize an individualized and specialized rehabilitation assessment of remoteness and intelligence, we set up a remote intelligent assessment system of upper limb movement function of post-stroke patients during rehabilitation. By using the remote rehabilitation training sensors and client data sampling software, we collected and uploaded the gesture data from a patient's forearm and upper arm during rehabilitation training to database of the server. Then a remote intelligent assessment system, which had been developed based on the extreme learning machine (ELM) algorithm and Brunnstrom stage assessment standard, was used to evaluate the gesture data. To evaluate the reliability of the proposed method, a group of 23 stroke patients, whose upper limb movement functions were in different recovery stages, and 4 healthy people, whose upper limb movement functions were normal, were recruited to finish the same training task. The results showed that, compared to that of the experienced rehabilitation expert who used the Brunnstrom stage standard table, the accuracy of the proposed remote Brunnstrom intelligent assessment system can reach a higher level, as 92.1%. The practical effects of surgery have proved that the proposed system could realize the intelligent assessment of upper limb movement function of post-stroke patients remotely, and it could also make the rehabilitation of the post-stroke patients at home or in a community care center possible.

Evaluating and Training Substance Abuse Counselors: A Pilot Study Assessing Standardized Patients as Authentic Clients

ERIC Educational Resources Information Center

Fussell, Holly E.; Lewy, Colleen S.; McFarland, Bentson H.

2009-01-01

Clinician training and supervision are needed to transfer evidence-based practices to community-based treatment organizations. Standardized patients (SPs) are used for clinician training and evaluating. However, to be effective for substance abuse counselors, SPs must realistically portray substance abuse treatment clients. The current study…

Intranets: virtual procedure manuals for the pathology lab.

PubMed

Ruby, S G; Krempel, G

1998-08-01

A novel system exists for replacing standard written operation manuals using a computerized PC-based peer-to-peer network. The system design is based on commonly available hardware and software and utilizes existing equipment to minimize implementation expense. The system is relatively easy to implement and maintain, involves minimal training, and should quickly become a financial asset. In addition, such a system can improve access to laboratory procedure manuals so that resources can be better used on a daily basis.

49 CFR 232.605 - Training requirements.

Code of Federal Regulations, 2010 CFR

2010-10-01

..., DEPARTMENT OF TRANSPORTATION BRAKE SYSTEM SAFETY STANDARDS FOR FREIGHT AND OTHER NON-PASSENGER TRAINS AND EQUIPMENT; END-OF-TRAIN DEVICES Electronically Controlled Pneumatic (ECP) Braking Systems § 232.605 Training... equipped with an ECP brake system and each contractor that performs inspection, testing, or maintenance on...

49 CFR 236.502 - Automatic brake application, initiation by restrictive block conditions stopping distance in...

Code of Federal Regulations, 2011 CFR

2011-10-01

... OF SIGNAL AND TRAIN CONTROL SYSTEMS, DEVICES, AND APPLIANCES Automatic Train Stop, Train Control and Cab Signal Systems Standards § 236.502 Automatic brake application, initiation by restrictive block conditions stopping distance in advance. An automatic train-stop or train-control system shall operate to...

Developing a Competency-Based Pan-European Accreditation Framework for Health Promotion

ERIC Educational Resources Information Center

Battel-Kirk, Barbara; Van der Zanden, Gerard; Schipperen, Marielle; Contu, Paolo; Gallardo, Carmen; Martinez, Ana; Garcia de Sola, Silvia; Sotgiu, Alessandra; Zaagsma, Miriam; Barry, Margaret M.

2012-01-01

Background: The CompHP Pan-European Accreditation Framework for Health Promotion was developed as part of the CompHP Project that aimed to develop competency-based standards and an accreditation system for health promotion practice, education, and training in Europe. Method: A phased, multiple-method approach was employed to facilitate consensus…

Training Standards in Neuroendovascular Surgery: Program Accreditation and Practitioner Certification.

PubMed

Day, Arthur L; Siddiqui, Adnan H; Meyers, Philip M; Jovin, Tudor G; Derdeyn, Colin P; Hoh, Brian L; Riina, Howard; Linfante, Italo; Zaidat, Osama; Turk, Aquilla; Howington, Jay U; Mocco, J; Ringer, Andrew J; Veznedaroglu, Erol; Khalessi, Alexander A; Levy, Elad I; Woo, Henry; Harbaugh, Robert; Giannotta, Steven

2017-08-01

Neuroendovascular surgery is a medical subspecialty that uses minimally invasive catheter-based technology and radiological imaging to diagnose and treat diseases of the central nervous system, head, neck, spine, and their vasculature. To perform these procedures, the practitioner needs an extensive knowledge of the anatomy of the nervous system, vasculature, and pathological conditions that affect their physiology. A working knowledge of radiation biology and safety is essential. Similarly, a sufficient volume of clinical and interventional experience, first as a trainee and then as a practitioner, is required so that these treatments can be delivered safely and effectively. This document has been prepared under the aegis of the Society of Neurological Surgeons and its Committee for Advanced Subspecialty Training in conjunction with the Joint Section of Cerebrovascular Surgery for the American Association of Neurological Surgeons and Congress of Neurological Surgeons, the Society of NeuroInterventional Surgery, and the Society of Vascular and Interventional Neurology. The material herein outlines the requirements for institutional accreditation of training programs in neuroendovascular surgery, as well as those needed to obtain individual subspecialty certification, as agreed on by Committee for Advanced Subspecialty Training, the Society of Neurological Surgeons, and the aforementioned Societies. This document also clarifies the pathway to certification through an advanced practice track mechanism for those current practitioners of this subspecialty who trained before Committee for Advanced Subspecialty Training standards were formulated. Representing neuroendovascular surgery physicians from neurosurgery, neuroradiology, and neurology, the above mentioned societies seek to standardize neuroendovascular surgery training to ensure the highest quality delivery of this subspecialty within the United States. © 2017 American Heart Association, Inc.

49 CFR 236.514 - Interconnection of cab signal system with roadway signal system.

Code of Federal Regulations, 2011 CFR

2011-10-01

... GOVERNING THE INSTALLATION, INSPECTION, MAINTENANCE, AND REPAIR OF SIGNAL AND TRAIN CONTROL SYSTEMS, DEVICES, AND APPLIANCES Automatic Train Stop, Train Control and Cab Signal Systems Standards § 236.514 Interconnection of cab signal system with roadway signal system. The automatic cab signal system shall be...

An assisted navigation training framework based on judgment theory using sparse and discrete human-machine interfaces.

PubMed

Lopes, Ana C; Nunes, Urbano

2009-01-01

This paper aims to present a new framework to train people with severe motor disabilities steering an assisted mobile robot (AMR), such as a powered wheelchair. Users with high level of motor disabilities are not able to use standard HMIs, which provide a continuous command signal (e. g. standard joystick). For this reason HMIs providing a small set of simple commands, which are sparse and discrete in time must be used (e. g. scanning interface, or brain computer interface), making very difficult to steer the AMR. In this sense, the assisted navigation training framework (ANTF) is designed to train users driving the AMR, in indoor structured environments, using this type of HMIs. Additionally it provides user characterization on steering the robot, which will later be used to adapt the AMR navigation system to human competence steering the AMR. A rule-based lens (RBL) model is used to characterize users on driving the AMR. Individual judgment performance choosing the best manoeuvres is modeled using a genetic-based policy capturing (GBPC) technique characterized to infer non-compensatory judgment strategies from human decision data. Three user models, at three different learning stages, using the RBL paradigm, are presented.

49 CFR 232.405 - Design and performance standards for two-way end-of-train devices.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 49 Transportation 4 2012-10-01 2012-10-01 false Design and performance standards for two-way end-of-train devices. 232.405 Section 232.405 Transportation Other Regulations Relating to Transportation (Continued) FEDERAL RAILROAD ADMINISTRATION, DEPARTMENT OF TRANSPORTATION BRAKE SYSTEM SAFETY STANDARDS FOR FREIGHT AND OTHER NON-PASSENGER TRAINS...

49 CFR 232.403 - Design standards for one-way end-of-train devices.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 49 Transportation 4 2012-10-01 2012-10-01 false Design standards for one-way end-of-train devices. 232.403 Section 232.403 Transportation Other Regulations Relating to Transportation (Continued) FEDERAL RAILROAD ADMINISTRATION, DEPARTMENT OF TRANSPORTATION BRAKE SYSTEM SAFETY STANDARDS FOR FREIGHT AND OTHER NON-PASSENGER TRAINS AND EQUIPMENT; EN...

49 CFR 232.605 - Training requirements.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 49 Transportation 4 2011-10-01 2011-10-01 false Training requirements. 232.605 Section 232.605..., DEPARTMENT OF TRANSPORTATION BRAKE SYSTEM SAFETY STANDARDS FOR FREIGHT AND OTHER NON-PASSENGER TRAINS AND EQUIPMENT; END-OF-TRAIN DEVICES Electronically Controlled Pneumatic (ECP) Braking Systems § 232.605 Training...

49 CFR 236.507 - Brake application; full service.

Code of Federal Regulations, 2011 CFR

2011-10-01

..., INSPECTION, MAINTENANCE, AND REPAIR OF SIGNAL AND TRAIN CONTROL SYSTEMS, DEVICES, AND APPLIANCES Automatic Train Stop, Train Control and Cab Signal Systems Standards § 236.507 Brake application; full service. The automatic train stop or train control apparatus shall, when operated, cause a full service...

49 CFR 236.507 - Brake application; full service.

Code of Federal Regulations, 2010 CFR

2010-10-01

..., INSPECTION, MAINTENANCE, AND REPAIR OF SIGNAL AND TRAIN CONTROL SYSTEMS, DEVICES, AND APPLIANCES Automatic Train Stop, Train Control and Cab Signal Systems Standards § 236.507 Brake application; full service. The automatic train stop or train control apparatus shall, when operated, cause a full service...

Evaluation of the MEMS based portable respiratory training system with a tactile sensor for respiratory-gated radiotherapy

NASA Astrophysics Data System (ADS)

Moon, Sun Young; Yoon, Myonggeun; Chung, Mijoo; Chung, Weon Kuu; Kim, Dong Wook

2017-10-01

In respiratory-gated radiotherapy, it is important to maintain the regular respiratory cycles of patients. If patients undergo respiration training, their regular breathing pattern is affected. Therefore, we developed a respiratory training system based on a micro electromechanical system (MEMS) and evaluated the feasibility of the MEMS in radiotherapy. By comparing the measured signal before and after radiation exposure, we confirmed the effects of radiation. By evaluating the period of the electric signal emitted by a tactile sensor and its constancy, the performance of the tactile sensor was confirmed. Moreover, by comparing the delay between the motion of the MEMS and the electric signal from the tactile sensor, we confirmed the reaction time of the tactile sensor. The results showed that a baseline shift occurred for an accumulated dose of 400 Gy in the sensor, and both the amplitude and period changed. The period of the signal released by the tactile sensor was 5.39 and its standard deviation was 0.06. Considering the errors from the motion phantom, a standard deviation of 0.06 was desirable. The delay time was within 0.5 s and not distinguishable by a patient. We confirmed the performance of the MEMS and concluded that MEMS could be applied to patients for respiratory-gated radiotherapy.

49 CFR 232.613 - End-of-train devices.

Code of Federal Regulations, 2010 CFR

2010-10-01

..., DEPARTMENT OF TRANSPORTATION BRAKE SYSTEM SAFETY STANDARDS FOR FREIGHT AND OTHER NON-PASSENGER TRAINS AND EQUIPMENT; END-OF-TRAIN DEVICES Electronically Controlled Pneumatic (ECP) Braking Systems § 232.613 End-of... equipped with an ECP brake system unless that train is equipped with a functioning ECP-EOT device designed...

A simulation-based training program improves emergency department staff communication.

PubMed

Sweeney, Lynn A; Warren, Otis; Gardner, Liz; Rojek, Adam; Lindquist, David G

2014-01-01

The objectives of this study were to evaluate the effectiveness of Project CLEAR!, a novel simulation-based training program designed to instill Crew Resource Management (CRM) as the communication standard and to create a service-focused environment in the emergency department (ED) by standardizing the patient encounter. A survey-based study compared physicians' and nurses' perceptions of the quality of communication before and after the training program. Surveys were developed to measure ED staff perceptions of the quality of communication between staff members and with patients. Pretraining and posttraining survey results were compared. After the training program, survey scores improved significantly on questions that asked participants to rate the overall communication between staff members and between staff and patients. A simulation-based training program focusing on CRM and standardizing the patient encounter improves communication in the ED, both between staff members and between staff members and patients.

Clinical effectiveness of combined virtual reality and robot assisted fine hand motion rehabilitation in subacute stroke patients.

PubMed

Huang, Xianwei; Naghdy, Fazel; Naghdy, Golshah; Du, Haiping

2017-07-01

Robot-assisted therapy is regarded as an effective and reliable method for the delivery of highly repetitive rehabilitation training in restoring motor skills after a stroke. This study focuses on the rehabilitation of fine hand motion skills due to their vital role in performing delicate activities of daily living (ADL) tasks. The proposed rehabilitation system combines an adaptive assist-as-needed (AAN) control algorithm and a Virtual Reality (VR) based rehabilitation gaming system (RGS). The developed system is described and its effectiveness is validated through clinical trials on a group of eight subacute stroke patients for a period of six weeks. The impact of the training is verified through standard clinical evaluation methods and measuring key kinematic parameters. A comparison of the pre- and post-training results indicates that the method proposed in this study can improve fine hand motion rehabilitation training effectiveness.

49 CFR 236.506 - Release of brakes after automatic application.

Code of Federal Regulations, 2010 CFR

2010-10-01

... INSTALLATION, INSPECTION, MAINTENANCE, AND REPAIR OF SIGNAL AND TRAIN CONTROL SYSTEMS, DEVICES, AND APPLIANCES Automatic Train Stop, Train Control and Cab Signal Systems Standards § 236.506 Release of brakes after automatic application. The automatic train stop or train control apparatus shall prevent release of the...

49 CFR 236.509 - Two or more locomotives coupled.

Code of Federal Regulations, 2010 CFR

2010-10-01

..., INSPECTION, MAINTENANCE, AND REPAIR OF SIGNAL AND TRAIN CONTROL SYSTEMS, DEVICES, AND APPLIANCES Automatic Train Stop, Train Control and Cab Signal Systems Standards § 236.509 Two or more locomotives coupled. The automatic train stop, train control or cab signal apparatus shall be arranged so that when two or...

49 CFR 236.506 - Release of brakes after automatic application.

Code of Federal Regulations, 2011 CFR

2011-10-01

... INSTALLATION, INSPECTION, MAINTENANCE, AND REPAIR OF SIGNAL AND TRAIN CONTROL SYSTEMS, DEVICES, AND APPLIANCES Automatic Train Stop, Train Control and Cab Signal Systems Standards § 236.506 Release of brakes after automatic application. The automatic train stop or train control apparatus shall prevent release of the...

49 CFR 236.509 - Two or more locomotives coupled.

Code of Federal Regulations, 2011 CFR

2011-10-01

..., INSPECTION, MAINTENANCE, AND REPAIR OF SIGNAL AND TRAIN CONTROL SYSTEMS, DEVICES, AND APPLIANCES Automatic Train Stop, Train Control and Cab Signal Systems Standards § 236.509 Two or more locomotives coupled. The automatic train stop, train control or cab signal apparatus shall be arranged so that when two or...

77 FR 16316 - Shipping Coordinating Committee; Notice of Committee Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2012-03-20

... strategy implementation plan. Development of training standards for recovery systems. Preparation of... Session of the International Maritime Organization's (IMO) Sub-Committee on Standards of Training and...

Towards case-based medical learning in radiological decision making using content-based image retrieval

PubMed Central

2011-01-01

Background Radiologists' training is based on intensive practice and can be improved with the use of diagnostic training systems. However, existing systems typically require laboriously prepared training cases and lack integration into the clinical environment with a proper learning scenario. Consequently, diagnostic training systems advancing decision-making skills are not well established in radiological education. Methods We investigated didactic concepts and appraised methods appropriate to the radiology domain, as follows: (i) Adult learning theories stress the importance of work-related practice gained in a team of problem-solvers; (ii) Case-based reasoning (CBR) parallels the human problem-solving process; (iii) Content-based image retrieval (CBIR) can be useful for computer-aided diagnosis (CAD). To overcome the known drawbacks of existing learning systems, we developed the concept of image-based case retrieval for radiological education (IBCR-RE). The IBCR-RE diagnostic training is embedded into a didactic framework based on the Seven Jump approach, which is well established in problem-based learning (PBL). In order to provide a learning environment that is as similar as possible to radiological practice, we have analysed the radiological workflow and environment. Results We mapped the IBCR-RE diagnostic training approach into the Image Retrieval in Medical Applications (IRMA) framework, resulting in the proposed concept of the IRMAdiag training application. IRMAdiag makes use of the modular structure of IRMA and comprises (i) the IRMA core, i.e., the IRMA CBIR engine; and (ii) the IRMAcon viewer. We propose embedding IRMAdiag into hospital information technology (IT) infrastructure using the standard protocols Digital Imaging and Communications in Medicine (DICOM) and Health Level Seven (HL7). Furthermore, we present a case description and a scheme of planned evaluations to comprehensively assess the system. Conclusions The IBCR-RE paradigm incorporates a novel combination of essential aspects of diagnostic learning in radiology: (i) Provision of work-relevant experiences in a training environment integrated into the radiologist's working context; (ii) Up-to-date training cases that do not require cumbersome preparation because they are provided by routinely generated electronic medical records; (iii) Support of the way adults learn while remaining suitable for the patient- and problem-oriented nature of medicine. Future work will address unanswered questions to complete the implementation of the IRMAdiag trainer. PMID:22032775

Towards case-based medical learning in radiological decision making using content-based image retrieval.

PubMed

Welter, Petra; Deserno, Thomas M; Fischer, Benedikt; Günther, Rolf W; Spreckelsen, Cord

2011-10-27

Radiologists' training is based on intensive practice and can be improved with the use of diagnostic training systems. However, existing systems typically require laboriously prepared training cases and lack integration into the clinical environment with a proper learning scenario. Consequently, diagnostic training systems advancing decision-making skills are not well established in radiological education. We investigated didactic concepts and appraised methods appropriate to the radiology domain, as follows: (i) Adult learning theories stress the importance of work-related practice gained in a team of problem-solvers; (ii) Case-based reasoning (CBR) parallels the human problem-solving process; (iii) Content-based image retrieval (CBIR) can be useful for computer-aided diagnosis (CAD). To overcome the known drawbacks of existing learning systems, we developed the concept of image-based case retrieval for radiological education (IBCR-RE). The IBCR-RE diagnostic training is embedded into a didactic framework based on the Seven Jump approach, which is well established in problem-based learning (PBL). In order to provide a learning environment that is as similar as possible to radiological practice, we have analysed the radiological workflow and environment. We mapped the IBCR-RE diagnostic training approach into the Image Retrieval in Medical Applications (IRMA) framework, resulting in the proposed concept of the IRMAdiag training application. IRMAdiag makes use of the modular structure of IRMA and comprises (i) the IRMA core, i.e., the IRMA CBIR engine; and (ii) the IRMAcon viewer. We propose embedding IRMAdiag into hospital information technology (IT) infrastructure using the standard protocols Digital Imaging and Communications in Medicine (DICOM) and Health Level Seven (HL7). Furthermore, we present a case description and a scheme of planned evaluations to comprehensively assess the system. The IBCR-RE paradigm incorporates a novel combination of essential aspects of diagnostic learning in radiology: (i) Provision of work-relevant experiences in a training environment integrated into the radiologist's working context; (ii) Up-to-date training cases that do not require cumbersome preparation because they are provided by routinely generated electronic medical records; (iii) Support of the way adults learn while remaining suitable for the patient- and problem-oriented nature of medicine. Future work will address unanswered questions to complete the implementation of the IRMAdiag trainer.

Job Grading Standard for Brakeman and Conductor WG-6003.

ERIC Educational Resources Information Center

Civil Service Commission, Washington, DC. Bureau of Policies and Standards.

The standard is used to grade the nonsupervisory work involved in coordinating (onsite) the movement, make up, or break up of trains, locomotives, and train cars. The work requires knowledge of the layout of a railroad track system; knowledge of and ability to follow numerous safety, signalling, switching, track use, train car, and train movement…

Effects of standard training in the use of closed-circuit televisions in visually impaired adults: design of a training protocol and a randomized controlled trial.

PubMed

Burggraaff, Marloes C; van Nispen, Ruth M A; Melis-Dankers, Bart J M; van Rens, Ger H M B

2010-03-10

Reading problems are frequently reported by visually impaired persons. A closed-circuit television (CCTV) can be helpful to maintain reading ability, however, it is difficult to learn how to use this device. In the Netherlands, an evidence-based rehabilitation program in the use of CCTVs was lacking. Therefore, a standard training protocol needed to be developed and tested in a randomized controlled trial (RCT) to provide an evidence-based training program in the use of this device. To develop a standard training program, information was collected by studying literature, observing training in the use of CCTVs, discussing the content of the training program with professionals and organizing focus and discussion groups. The effectiveness of the program was evaluated in an RCT, to obtain an evidence-based training program. Dutch patients (n = 122) were randomized into a treatment group: normal instructions from the supplier combined with training in the use of CCTVs, or into a control group: instructions from the supplier only. The effect of the training program was evaluated in terms of: change in reading ability (reading speed and reading comprehension), patients' skills to operate the CCTV, perceived (vision-related) quality of life and tasks performed in daily living. The development of the CCTV training protocol and the design of the RCT in the present study may serve as an example to obtain an evidence-based training program. The training program was adjusted to the needs and learning abilities of individual patients, however, for scientific reasons it might have been preferable to standardize the protocol further, in order to gain more comparable results. http://www.trialregister.nl, identifier: NTR1031.

Effects of standard training in the use of closed-circuit televisions in visually impaired adults: design of a training protocol and a randomized controlled trial

PubMed Central

2010-01-01

Background Reading problems are frequently reported by visually impaired persons. A closed-circuit television (CCTV) can be helpful to maintain reading ability, however, it is difficult to learn how to use this device. In the Netherlands, an evidence-based rehabilitation program in the use of CCTVs was lacking. Therefore, a standard training protocol needed to be developed and tested in a randomized controlled trial (RCT) to provide an evidence-based training program in the use of this device. Methods/Design To develop a standard training program, information was collected by studying literature, observing training in the use of CCTVs, discussing the content of the training program with professionals and organizing focus and discussion groups. The effectiveness of the program was evaluated in an RCT, to obtain an evidence-based training program. Dutch patients (n = 122) were randomized into a treatment group: normal instructions from the supplier combined with training in the use of CCTVs, or into a control group: instructions from the supplier only. The effect of the training program was evaluated in terms of: change in reading ability (reading speed and reading comprehension), patients' skills to operate the CCTV, perceived (vision-related) quality of life and tasks performed in daily living. Discussion The development of the CCTV training protocol and the design of the RCT in the present study may serve as an example to obtain an evidence-based training program. The training program was adjusted to the needs and learning abilities of individual patients, however, for scientific reasons it might have been preferable to standardize the protocol further, in order to gain more comparable results. Trial registration http://www.trialregister.nl, identifier: NTR1031 PMID:20219120

Strategically Leapfrogging Education in Prehospital Trauma Management: Four-Tiered Training Protocols

PubMed Central

Abraham, Rohit; Vyas, Dinesh; Narayan, Mayur; Vyas, Arpita

2016-01-01

Trauma-related injury in fast developing countries are linked to 90% of international mortality rates, which can be greatly reduced by improvements in often non-existent or non-centralized emergency medical systems (EMS)—particularly in the pre-hospital care phase. Traditional trauma training protocols—such as Advanced Trauma Life Support (ATLS), International Trauma Life Support (ITLS), and Basic Life Support (BLS)—have failed to produce an effective pre-hospital ground force of medical first responders. To overcome these barriers, we propose a new four-tiered set of trauma training protocols: Massive Open Online Course (MOOC) Trauma Training, Acute Trauma Training (ATT), Broad Trauma Training (BTT), and Cardiac and Trauma Training (CTT). These standards are specifically differentiated to accommodate the educational and socioeconomic diversity found in fast developing settings, where each free course is taught in native, lay language while ensuring the education standards are maintained by fully incorporating high-fidelity simulation, video-recorded debriefing, and retraining. The innovative pedagogy of this trauma education program utilizes MOOC for global scalability and a “train-the-trainer” approach for exponential growth—both components help fast developing countries reach a critical mass of first responders needed for the base of an evolving EMS. PMID:27419222

Strategically Leapfrogging Education in Prehospital Trauma Management: Four-Tiered Training Protocols.

PubMed

Abraham, Rohit; Vyas, Dinesh; Narayan, Mayur; Vyas, Arpita

2015-12-01

Trauma-related injury in fast developing countries are linked to 90% of international mortality rates, which can be greatly reduced by improvements in often non-existent or non-centralized emergency medical systems (EMS)-particularly in the pre-hospital care phase. Traditional trauma training protocols-such as Advanced Trauma Life Support (ATLS), International Trauma Life Support (ITLS), and Basic Life Support (BLS)-have failed to produce an effective pre-hospital ground force of medical first responders. To overcome these barriers, we propose a new four-tiered set of trauma training protocols: Massive Open Online Course (MOOC) Trauma Training, Acute Trauma Training (ATT), Broad Trauma Training (BTT), and Cardiac and Trauma Training (CTT). These standards are specifically differentiated to accommodate the educational and socioeconomic diversity found in fast developing settings, where each free course is taught in native, lay language while ensuring the education standards are maintained by fully incorporating high-fidelity simulation, video-recorded debriefing, and retraining. The innovative pedagogy of this trauma education program utilizes MOOC for global scalability and a "train-the-trainer" approach for exponential growth-both components help fast developing countries reach a critical mass of first responders needed for the base of an evolving EMS.

Modeling and simulation for space medicine operations: preliminary requirements considered

NASA Technical Reports Server (NTRS)

Dawson, D. L.; Billica, R. D.; McDonald, P. V.

2001-01-01

The NASA Space Medicine program is now developing plans for more extensive use of high-fidelity medical simulation systems. The use of simulation is seen as means to more effectively use the limited time available for astronaut medical training. Training systems should be adaptable for use in a variety of training environments, including classrooms or laboratories, space vehicle mockups, analog environments, and in microgravity. Modeling and simulation can also provide the space medicine development program a mechanism for evaluation of other medical technologies under operationally realistic conditions. Systems and procedures need preflight verification with ground-based testing. Traditionally, component testing has been accomplished, but practical means for "human in the loop" verification of patient care systems have been lacking. Medical modeling and simulation technology offer potential means to accomplish such validation work. Initial considerations in the development of functional requirements and design standards for simulation systems for space medicine are discussed.

Requirements for Modeling and Simulation for Space Medicine Operations: Preliminary Considerations

NASA Technical Reports Server (NTRS)

Dawson, David L.; Billica, Roger D.; Logan, James; McDonald, P. Vernon

2001-01-01

The NASA Space Medicine program is now developing plans for more extensive use of high-fidelity medical Simulation systems. The use of simulation is seen as means to more effectively use the limited time available for astronaut medical training. Training systems should be adaptable for use in a variety of training environments, including classrooms or laboratories, space vehicle mockups, analog environments, and in microgravity. Modeling and simulation can also provide the space medicine development program a mechanism for evaluation of other medical technologies under operationally realistic conditions. Systems and procedures need preflight verification with ground-based testing. Traditionally, component testing has been accomplished, but practical means for "human in the loop" verification of patient care systems have been lacking. Medical modeling and simulation technology offer potential means to accomplish such validation work. Initial considerations in the development of functional requirements and design standards for simulation systems for space medicine are discussed.

A Single Session of Mirror-based Tactile and Motor Training Improves Tactile Dysfunction in Children with Unilateral Cerebral Palsy: A Replicated Randomized Controlled Case Series.

PubMed

Auld, Megan L; Johnston, Leanne M; Russo, Remo N; Moseley, G Lorimer

2017-10-01

This replicated randomized controlled crossover case series investigated the effect of mirror-based tactile and motor training on tactile registration and perception in children with unilateral cerebral palsy (UCP). Six children with UCP (6-18 years; median 10 years, five male, three-left hemiplegia, four-manual ability classification system (MACS) I, one MACS II and one MACS III) participated. They attended two 90-minute sessions - one of mirror-based training and one of standard practice, bimanual therapy - in alternated order. Tactile registration (Semmes Weinstein Monofilaments) and perception (double simultaneous or single-point localization) were assessed before and after each session. Change was estimated using reliable change index (RCI). Tactile perception improved in four participants (RCI > 1.75), with mirror-based training, but was unchanged with bimanual therapy (RCI < 1.0 for all participants). Neither intervention affected tactile registration. Mirror-based training demonstrates potential to improve tactile perception in children with UCP. Copyright © 2016 John Wiley & Sons, Ltd. Copyright © 2016 John Wiley & Sons, Ltd.

Automating individualized coaching and authentic role-play practice for brief intervention training.

PubMed

Hayes-Roth, B; Saker, R; Amano, K

2010-01-01

Brief intervention helps to reduce alcohol abuse, but there is a need for accessible, cost-effective training of clinicians. This study evaluated STAR Workshop , a web-based training system that automates efficacious techniques for individualized coaching and authentic role-play practice. We compared STAR Workshop to a web-based, self-guided e-book and a no-treatment control, for training the Engage for Change (E4C) brief intervention protocol. Subjects were medical and nursing students. Brief written skill probes tested subjects' performance of individual protocol steps, in different clinical scenarios, at three test times: pre-training, post-training, and post-delay (two weeks). Subjects also did live phone interviews with a standardized patient, post-delay. STAR subjects performed significantly better than both other groups. They showed significantly greater improvement from pre-training probes to post-training and post-delay probes. They scored significantly higher on post-delay phone interviews. STAR Workshop appears to be an accessible, cost-effective approach for training students to use the E4C protocol for brief intervention in alcohol abuse. It may also be useful for training other clinical interviewing protocols.

A Framework for Defining and Assessing Occupational and Training Standards in Developing Countries. Information Series.

ERIC Educational Resources Information Center

Fretwell, David H.; Lewis, Morgan V.; Deij, Arjen

The key issues, alternatives, and implications for developing countries to consider when designing systems to define occupational standards, related training standards, and assessments were analyzed. The analysis focused on the following issues: the rationale for development of standards; clarification of definitions, terminology, and assumptions;…

Peculiarities of Professional Training Standards Development and Implementation within Competency-Based Approach: Foreign Experience

ERIC Educational Resources Information Center

Desyatov, Tymofiy

2015-01-01

The article analyzes the development of competency-based professional training standards and their implementation into educational process in foreign countries. It determines that the main idea of competency-based approach is competency-and-active learning, which aims at complex acquirement of diverse skills and ways of practice activities via…

On your time: online training for the public health workforce.

PubMed

Kenefick, Hope Worden; Ravid, Sharon; MacVarish, Kathleen; Tsoi, Jennifer; Weill, Kenny; Faye, Elizabeth; Fidler, Anne

2014-03-01

The need for competency-based training for the public health workforce is well documented. However, human and financial resource limitations within public health agencies often make it difficult for public health practitioners to attend classroom-based training programs. The Internet is an increasingly popular way of extending training beyond the workforce. Although research describes attributes of effective online learning modules, much of the available training delivered via the Internet does not incorporate such attributes. The authors describe the On Your Time training series, an effective distance education program and training model for public health practitioners, which includes a standardized process for development, review, evaluation, and continuous quality improvement. On Your Time is a series of awareness-level (i.e., addressing what practitioners should know), competency-based training modules that address topics related to regulatory responsibilities of public health practitioners (e.g., assuring compliance with codes and regulations governing housing, retail food safety, private water supplies, hazardous and solid waste, on-site wastewater systems, etc.), public health surveillance, case investigation, disease prevention, health promotion, and emergency preparedness. The replicable model incorporates what is known about best practices for online training and maximizes available resources in the interests of sustainability.

49 CFR 236.508 - Interference with application of brakes by means of brake valve.

Code of Federal Regulations, 2011 CFR

2011-10-01

... GOVERNING THE INSTALLATION, INSPECTION, MAINTENANCE, AND REPAIR OF SIGNAL AND TRAIN CONTROL SYSTEMS, DEVICES, AND APPLIANCES Automatic Train Stop, Train Control and Cab Signal Systems Standards § 236.508 Interference with application of brakes by means of brake valve. The automatic train stop, train control, or...

49 CFR 236.508 - Interference with application of brakes by means of brake valve.

Code of Federal Regulations, 2010 CFR

2010-10-01

... GOVERNING THE INSTALLATION, INSPECTION, MAINTENANCE, AND REPAIR OF SIGNAL AND TRAIN CONTROL SYSTEMS, DEVICES, AND APPLIANCES Automatic Train Stop, Train Control and Cab Signal Systems Standards § 236.508 Interference with application of brakes by means of brake valve. The automatic train stop, train control, or...

Prefrontal cortex as a meta-reinforcement learning system.

PubMed

Wang, Jane X; Kurth-Nelson, Zeb; Kumaran, Dharshan; Tirumala, Dhruva; Soyer, Hubert; Leibo, Joel Z; Hassabis, Demis; Botvinick, Matthew

2018-06-01

Over the past 20 years, neuroscience research on reward-based learning has converged on a canonical model, under which the neurotransmitter dopamine 'stamps in' associations between situations, actions and rewards by modulating the strength of synaptic connections between neurons. However, a growing number of recent findings have placed this standard model under strain. We now draw on recent advances in artificial intelligence to introduce a new theory of reward-based learning. Here, the dopamine system trains another part of the brain, the prefrontal cortex, to operate as its own free-standing learning system. This new perspective accommodates the findings that motivated the standard model, but also deals gracefully with a wider range of observations, providing a fresh foundation for future research.

Big data driven cycle time parallel prediction for production planning in wafer manufacturing

NASA Astrophysics Data System (ADS)

Wang, Junliang; Yang, Jungang; Zhang, Jie; Wang, Xiaoxi; Zhang, Wenjun Chris

2018-07-01

Cycle time forecasting (CTF) is one of the most crucial issues for production planning to keep high delivery reliability in semiconductor wafer fabrication systems (SWFS). This paper proposes a novel data-intensive cycle time (CT) prediction system with parallel computing to rapidly forecast the CT of wafer lots with large datasets. First, a density peak based radial basis function network (DP-RBFN) is designed to forecast the CT with the diverse and agglomerative CT data. Second, the network learning method based on a clustering technique is proposed to determine the density peak. Third, a parallel computing approach for network training is proposed in order to speed up the training process with large scaled CT data. Finally, an experiment with respect to SWFS is presented, which demonstrates that the proposed CTF system can not only speed up the training process of the model but also outperform the radial basis function network, the back-propagation-network and multivariate regression methodology based CTF methods in terms of the mean absolute deviation and standard deviation.

Web-Based Versus Conventional Training for Medical Students on Infant Gross Motor Screening.

PubMed

Pusponegoro, Hardiono D; Soebadi, Amanda; Surya, Raymond

2015-12-01

Early detection of developmental abnormalities is important for early intervention. A simple screening method is needed for use by general practitioners, as is an effective and efficient training method. This study aims to evaluate the effectiveness, acceptability, and usability of Web-based training for medical students on a simple gross motor screening method in infants. Fifth-year medical students at University of Indonesia in Jakarta were randomized into two groups. A Web-based training group received online video modules, discussions, and assessments (at www.schoology.com ). A conventional training group received a 1-day live training using the same module. Both groups completed identical pre- and posttests and the User Satisfaction Questionnaire (USQ). The Web-based group also completed the System Usability Scale (SUS). The module was based on a gross motor screening method used in the World Health Organization Multicentre Growth Reference Study. There were 39 and 32 subjects in the Web-based and conventional groups, respectively. Mean pretest versus posttest scores (correct answers out of 20) were 9.05 versus 16.95 (p=0.0001) in the Web-based group and 9.31 versus 16.88 (p=0.0001) in the conventional group. Mean difference between pre- and posttest scores did not differ significantly between the Web-based and conventional groups (mean [standard deviation], 7.56 [3.252] versus 7.90 [5.170]; p=0.741]. Both training methods were acceptable based on USQ scores. Based on SUS scores, the Web-based training had good usability. Web-based training is an effective, efficient, and acceptable training method for medical students on simple infant gross motor screening and is as effective as conventional training.

49 CFR 236.513 - Audible indicator.

Code of Federal Regulations, 2010 CFR

2010-10-01

..., MAINTENANCE, AND REPAIR OF SIGNAL AND TRAIN CONTROL SYSTEMS, DEVICES, AND APPLIANCES Automatic Train Stop, Train Control and Cab Signal Systems Standards § 236.513 Audible indicator. (a) The automatic cab signal... control system shall have a distinctive sound and be clearly audible throughout the cab under all...

49 CFR 236.513 - Audible indicator.

Code of Federal Regulations, 2011 CFR

2011-10-01

..., MAINTENANCE, AND REPAIR OF SIGNAL AND TRAIN CONTROL SYSTEMS, DEVICES, AND APPLIANCES Automatic Train Stop, Train Control and Cab Signal Systems Standards § 236.513 Audible indicator. (a) The automatic cab signal... control system shall have a distinctive sound and be clearly audible throughout the cab under all...

The National Teacher Training Institute for Math, Science and Technology: Exemplary Practice in a Climate of Higher Standards.

ERIC Educational Resources Information Center

Donlevy, James G., Ed.; Donlevy, Tia Rice, Ed.

1999-01-01

Reviews the NTTI (National Teacher Training Institute) for Math, Science and Technology model that trains teachers to use video and Internet resources to enhance math and science instruction. Discusses multimedia methodology; standards-based training; program impact in schools; and lesson plans available on the NTTI Web site. (Author/LRW)

Wearable Technology for Global Surgical Teleproctoring.

PubMed

Datta, Néha; MacQueen, Ian T; Schroeder, Alexander D; Wilson, Jessica J; Espinoza, Juan C; Wagner, Justin P; Filipi, Charles J; Chen, David C

2015-01-01

In underserved communities around the world, inguinal hernias represent a significant burden of surgically-treatable disease. With traditional models of international surgical assistance limited to mission trips, a standardized framework to strengthen local healthcare systems is lacking. We established a surgical education model using web-based tools and wearable technology to allow for long-term proctoring and assessment in a resource-poor setting. This is a feasibility study examining wearable technology and web-based performance rating tools for long-term proctoring in an international setting. Using the Lichtenstein inguinal hernia repair as the index surgical procedure, local surgeons in Paraguay and Brazil were trained in person by visiting international expert trainers using a formal, standardized teaching protocol. Surgeries were captured in real-time using Google Glass and transmitted wirelessly to an online video stream, permitting real-time observation and proctoring by mentoring surgeon experts in remote locations around the world. A system for ongoing remote evaluation and support by experienced surgeons was established using the Lichtenstein-specific Operative Performance Rating Scale. Data were collected from 4 sequential training operations for surgeons trained in both Paraguay and Brazil. With continuous internet connectivity, live streaming of the surgeries was successful. The Operative Performance Rating Scale was immediately used after each operation. Both surgeons demonstrated proficiency at the completion of the fourth case. A sustainable model for surgical training and proctoring to empower local surgeons in resource-poor locations and "train trainers" is feasible with wearable technology and web-based communication. Capacity building by maximizing use of local resources and expertise offers a long-term solution to reducing the global burden of surgically-treatable disease. Copyright © 2015 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

Effectiveness of a multi-level implementation strategy for ASD interventions: study protocol for two linked cluster randomized trials.

PubMed

Brookman-Frazee, Lauren; Stahmer, Aubyn C

2018-05-09

The Centers for Disease Control (2018) estimates that 1 in 59 children has autism spectrum disorder, and the annual cost of ASD in the U.S. is estimated to be $236 billion. Evidence-based interventions have been developed and demonstrate effectiveness in improving child outcomes. However, research on generalizable methods to scale up these practices in the multiple service systems caring for these children has been limited and is critical to meet this growing public health need. This project includes two, coordinated studies testing the effectiveness of the Translating Evidence-based Interventions (EBI) for ASD: Multi-Level Implementation Strategy (TEAMS) model. TEAMS focuses on improving implementation leadership, organizational climate, and provider attitudes and motivation in order to improve two key implementation outcomes-provider training completion and intervention fidelity and subsequent child outcomes. The TEAMS Leadership Institute applies implementation leadership strategies and TEAMS Individualized Provider Strategies for training applies motivational interviewing strategies to facilitate provider and organizational behavior change. A cluster randomized implementation/effectiveness Hybrid, type 3, trial with a dismantling design will be used to understand the effectiveness of TEAMS and the mechanisms of change across settings and participants. Study #1 will test the TEAMS model with AIM HI (An Individualized Mental Health Intervention for ASD) in publicly funded mental health services. Study #2 will test TEAMS with CPRT (Classroom Pivotal Response Teaching) in education settings. Thirty-seven mental health programs and 37 school districts will be randomized, stratified by county and study, to one of four groups (Standard Provider Training Only, Standard Provider Training + Leader Training, Enhanced Provider Training, Enhanced Provider Training + Leader Training) to test the effectiveness of combining standard, EBI-specific training with the two TEAMS modules individually and together on multiple implementation outcomes. Implementation outcomes including provider training completion, fidelity (coded by observers blind to group assignment) and child behavior change will be examined for 295 mental health providers, 295 teachers, and 590 children. This implementation intervention has the potential to increase quality of care for ASD in publicly funded settings by improving effectiveness of intervention implementation. The process and modules will be generalizable to multiple service systems, providers, and interventions, providing broad impact in community services. This study is registered with Clinicaltrials.gov ( NCT03380078 ). Registered 20 December 2017, retrospectively registered.

Nuclear materials control and accountability (NMC and A) auditors in the 90's

DOE Office of Scientific and Technical Information (OSTI.GOV)

Barham, M.A.; Abbott, R.R.

1991-01-01

The increase in emphasis on the adequacy of the NMC and A internal control systems requires that management define what type of training and experience is needed by NMC and A Internal Audit Program. At Martin Marietta Energy Systems, inc. (the prime contractor for the Department of Energy at Oak Ridge, Tenn.), the Central NMC and A Manager has developed a comprehensive set of NMC and A Internal Audit policies that defines performance standards, methods of conducting audits, mechanisms for ensuring appropriate independence for NMC and A auditors, structure for standardized audit reports and working papers, and a section thatmore » addresses the development of training plans for individual NMC and A auditors. The training requirements reflect the unique combination of skills necessary to be an effective NMC and A Internal Auditor- a combination of the operational auditing skills of a Certified Internal Auditor, the accounting auditing capabilities of a Certified Public Accountant, and the specific technical knowledge base associated with nuclear materials. This paper presents a mechanism for identifying an individual training program for NMC and A auditors that considers the above requirements and the individual's long-range career goals.« less

75 FR 52059 - Petition for Waiver of Compliance

Federal Register 2010, 2011, 2012, 2013, 2014

2010-08-24

... with certain requirements of 49 CFR part 232 -- Brake System Safety Standards for Freight and Other Non-Passenger Trains and Equipment; End-of Train Devices and CFR Part 215--Railroad Freight Car Safety Standards... requirements of its safety standards. The individual petition is described below, including the party seeking...

Developing Behavioural Training Services to Meet Defined Standards within an Australian Statewide Disability Service System and the Associated Client Outcomes

ERIC Educational Resources Information Center

Crates, Nicola; Spicer, Matthew

2012-01-01

Background: LaVigna, Christian, and Willis (2005) reported on a project where Institute for Applied Behaviour Analysis (IABA) staff trained a professional team in New Zealand (NZ) to provide behavioural services that met defined criteria. The NZ team was then trained to train other practitioners to meet the same professional standards. However, no…

49 CFR 236.511 - Cab signals controlled in accordance with block conditions stopping distance in advance.

Code of Federal Regulations, 2011 CFR

2011-10-01

... INSTRUCTIONS GOVERNING THE INSTALLATION, INSPECTION, MAINTENANCE, AND REPAIR OF SIGNAL AND TRAIN CONTROL SYSTEMS, DEVICES, AND APPLIANCES Automatic Train Stop, Train Control and Cab Signal Systems Standards... automatic cab signal system shall be arranged so that cab signals will be continuously controlled in...

Use of a Standardized Patient Exercise to Assess Core Competencies During Fellowship Training

PubMed Central

Barry, Curtis T.; Avissar, Uri; Asebrook, Maureen; Sostok, Michael A.; Sherman, Kenneth E.; Zucker, Stephen D.

2010-01-01

Background The Accreditation Council for Graduate Medical Education requires fellows in many specialties to demonstrate attainment of 6 core competencies, yet relatively few validated assessment tools currently exist. We present our initial experience with the design and implementation of a standardized patient (SP) exercise during gastroenterology fellowship that facilitates appraisal of all core clinical competencies. Methods Fellows evaluated an SP trained to portray an individual referred for evaluation of abnormal liver tests. The encounters were independently graded by the SP and a faculty preceptor for patient care, professionalism, and interpersonal and communication skills using quantitative checklist tools. Trainees' consultation notes were scored using predefined key elements (medical knowledge) and subjected to a coding audit (systems-based practice). Practice-based learning and improvement was addressed via verbal feedback from the SP and self-assessment of the videotaped encounter. Results Six trainees completed the exercise. Second-year fellows received significantly higher scores in medical knowledge (55.0 ± 4.2 [standard deviation], P  =  .05) and patient care skills (19.5 ± 0.7, P  =  .04) by a faculty evaluator as compared with first-year trainees (46.2 ± 2.3 and 14.7 ± 1.5, respectively). Scores correlated by Spearman rank (0.82, P  =  .03) with the results of the Gastroenterology Training Examination. Ratings of the fellows by the SP did not differ by level of training, nor did they correlate with faculty scores. Fellows viewed the exercise favorably, with most indicating they would alter their practice based on the experience. Conclusions An SP exercise is an efficient and effective tool for assessing core clinical competencies during fellowship training. PMID:21975896

[Undergraduate psychiatric training in Turkey].

PubMed

Cıngı Başterzi, Ayşe Devrim; Tükel, Raşit; Uluşahin, Aylin; Coşkun, Bülent; Alkın, Tunç; Murat Demet, Mehmet; Konuk, Numan; Taşdelen, Bahar

2010-01-01

The current trend in medical education is to abandon the experience-based traditional model and embrace the competency-based education model (CBE). The basic principle behind CBE is standardization. The first step in standardization is to determine what students must know, what they must accomplish, and what attitude they should display, and the establishment of educational goals. One of the goals of the Psychiatric Association of Turkey, Psychiatric Training Section is to standardize psychiatric training in Turkish medical schools. This study aimed to determine the current state of undergraduate psychiatric training in Turkish medical schools. Questionnaires were sent to the psychiatry department chairs of 41 medical schools. Data were analyzed using descriptive statistical methods. Of the 41 department chairs that were sent the questionnaire, 29 (70%) completed and returned them, of which 16 (66.7%) reported that they had already defined goals and educational objectives for their undergraduate psychiatric training programs. The Core Education Program, prepared by the Turkish Medicine and Health Education Council, was predominately used at 9 (37.5%) medical schools. Pre-clinical and clinical training schedules varied between medical schools. In all, 3 of the medical schools did not offer internships in psychiatry. The majority of chairs emphasized the importance of mood disorders (49.9%) and anxiety disorders (40%), suggesting that these disorders should be treated by general practitioners. Computer technology was commonly used for lecturing; however, utilization of interactive and skill-based teaching methods was limited. The most commonly used evaluation methods were written examination (87.5%) during preclinical training and oral examination (91.6%) during clinical training. The most important finding of this study was the lack of a standardized curriculum for psychiatric training in Turkey. Standardization of psychiatric training in Turkish medical schools must be developed.

Immersive virtual reality used as a platform for perioperative training for surgical residents.

PubMed

Witzke, D B; Hoskins, J D; Mastrangelo, M J; Witzke, W O; Chu, U B; Pande, S; Park, A E

2001-01-01

Perioperative preparations such as operating room setup, patient and equipment positioning, and operating port placement are essential to operative success in minimally invasive surgery. We developed an immersive virtual reality-based training system (REMIS) to provide residents (and other health professionals) with training and evaluation in these perioperative skills. Our program uses the qualities of immersive VR that are available today for inclusion in an ongoing training curriculum for surgical residents. The current application consists of a primary platform for patient positioning for a laparoscopic cholecystectomy. Having completed this module we can create many different simulated problems for other procedures. As a part of the simulation, we have devised a computer-driven real-time data collection system to help us in evaluating trainees and providing feedback during the simulation. The REMIS program trains and evaluates surgical residents and obviates the need to use expensive operating room and surgeon time. It also allows residents to train based on their schedule and does not put patients at increased risk. The method is standardized, allows for repetition if needed, evaluates individual performance, provides the possible complications of incorrect choices, provides training in 3-D environment, and has the capability of being used for various scenarios and professions.

Electronic implementation of national nursing standards--NANDA, NOC and NIC as an effective teaching tool.

PubMed

Allred, Sharon K; Smith, Kevin F; Flowers, Laura

2004-01-01

With the increased interest in evidence-based medicine, Internet access and the growing emphasis on national standards, there is an increased challenge for teaching institutions and nursing services to teach and implement standards. At the same time, electronic clinical documentation tools have started to become a common format for recording nursing notes. The major aim of this paper is to ascertain and assess the availability of clinical nursing tools based on the NANDA, NOC and NIC standards. Faculty at 20 large nursing schools and directors of nursing at 20 hospitals were interviewed regarding the use of nursing standards in clinical documentation packages, not only for teaching purposes but also for use in hospital-based systems to ensure patient safety. A survey tool was utilized that covered questions regarding what nursing standards are being taught in the nursing schools, what standards are encouraged by the hospitals, and teaching initiatives that include clinical documentation tools. Information was collected on how utilizing these standards in a clinical or hospital setting can improve the overall quality of care. Analysis included univariate and bivariate analysis. The consensus between both groups was that the NANDA, NOC and NIC national standards are the most widely taught and utilized. In addition, a training initiative was identified within a large university where a clinical documentation system based on these standards was developed utilizing handheld devices.

Applying an innovative educational program for the education of today's engineers

NASA Astrophysics Data System (ADS)

Kans, M.

2012-05-01

Engineers require a broad spectrum of knowledge and skills: basic skills in mathematics and physics, skills and competencies within the major subject area as well as more general knowledge about business and enterprise contexts, society regulations and understanding of the future professions' characteristics. In addition, social, intercultural, analytical and managing competencies are desired. The CDIO educational program was initiated as a means to come closer to practice and to assure the training of engineering skills that are required of today's engineers. CDIO is short for Conceive-Design-Implement-Operate and describes the full life cycle understanding of a system or asset that engineering students should reach during education. The CDIO initiative is formulated in a program consisting of two important documents: the CDIO standards and the CDIO syllabus. The standards describe a holistic approach on education, from knowledge and skills to be trained, how to train and assess them, to how to develop the teaching staff and the work places for enabling the goals. The specific knowledge and skills to be achieved are accounted for in the syllabus. In this paper we share our more than 15 years of experiences in problem and project based learning from the perspective of the CDIO standards. For each standard, examples of how to set up the education and overcome challenges connected to the standard are given. The paper concludes with recommendations to others wishing to work toward problem and real-life based education without compromising the requirements of a scientific approach.

[Evaluation of a training system for middle ear surgery with optoelectric detection].

PubMed

Strauss, G; Bahrami, N; Pössneck, A; Strauss, M; Dietz, A; Korb, W; Lüth, T; Haase, R; Moeckel, H; Grunert, R

2009-10-01

This work presents a new training concept for surgery of the temporal bone. It is based on a model of gypsum plastic with optoelectric detection of risk structures. A prototypical evaluation is given. The training models are based on high-resolution computed tomographic data of a human skull. The resulting data set was printed by a three-dimensional (3D) printer. A 3D phantom is created from gypsum powder and a bonding agent. Risks structures are the facial nerve, semicircular canal, cochlea, ossicular chain, sigmoid sinus, dura, and internal carotid artery. An electrically conductive metal (Wood's metal) and a fiber-optic cable were used as detection materials for the risk structures. For evaluating the training system, a study was done with eight inexperienced and eight experienced ear surgeons. They were asked to perform temporal bone surgery using two identical training models (group A). In group B, the same surgeons underwent surgical training with human cadavers. In the case of injuries, the number, point in time, degree (facial nerve), and injured structure were documented during the training on the model. In addition, the total time needed was noted. The training systems could be used in all cases. Evaluation of the anatomic accuracy of the models showed results that were between 49.5% and 90% agreement with the anatomic origin. Error detection was evaluated with values between 79% and 100% agreement with the perception of an experienced surgeon. The operating setting was estimated to be better than the previous"gold standard." The possibility of completely replacing the previous training method, which uses cadavers, with the examined training model was affirmed. This study shows that the examined system fulfills the conditions for a new training concept for temporal bone surgery. The system connects the preliminary work with printed and sintered models with the possibilities of microsystem engineering. In addition, the model's digital database permits a complete virtual representation of the model with appropriate further applications ("look behind the wall," virtual endoscopy).

49 CFR 236.505 - Proper operative relation between parts along roadway and parts on locomotive.

Code of Federal Regulations, 2012 CFR

2012-10-01

... INSTRUCTIONS GOVERNING THE INSTALLATION, INSPECTION, MAINTENANCE, AND REPAIR OF SIGNAL AND TRAIN CONTROL SYSTEMS, DEVICES, AND APPLIANCES Automatic Train Stop, Train Control and Cab Signal Systems Standards... all conditions of speed, weather, wear, oscillation, and shock. ...

49 CFR 236.505 - Proper operative relation between parts along roadway and parts on locomotive.

Code of Federal Regulations, 2011 CFR

2011-10-01

... INSTRUCTIONS GOVERNING THE INSTALLATION, INSPECTION, MAINTENANCE, AND REPAIR OF SIGNAL AND TRAIN CONTROL SYSTEMS, DEVICES, AND APPLIANCES Automatic Train Stop, Train Control and Cab Signal Systems Standards... all conditions of speed, weather, wear, oscillation, and shock. ...

49 CFR 236.505 - Proper operative relation between parts along roadway and parts on locomotive.

Code of Federal Regulations, 2014 CFR

2014-10-01

... INSTRUCTIONS GOVERNING THE INSTALLATION, INSPECTION, MAINTENANCE, AND REPAIR OF SIGNAL AND TRAIN CONTROL SYSTEMS, DEVICES, AND APPLIANCES Automatic Train Stop, Train Control and Cab Signal Systems Standards... all conditions of speed, weather, wear, oscillation, and shock. ...

49 CFR 236.505 - Proper operative relation between parts along roadway and parts on locomotive.

Code of Federal Regulations, 2010 CFR

2010-10-01

... INSTRUCTIONS GOVERNING THE INSTALLATION, INSPECTION, MAINTENANCE, AND REPAIR OF SIGNAL AND TRAIN CONTROL SYSTEMS, DEVICES, AND APPLIANCES Automatic Train Stop, Train Control and Cab Signal Systems Standards... all conditions of speed, weather, wear, oscillation, and shock. ...

49 CFR 236.505 - Proper operative relation between parts along roadway and parts on locomotive.

Code of Federal Regulations, 2013 CFR

2013-10-01

... INSTRUCTIONS GOVERNING THE INSTALLATION, INSPECTION, MAINTENANCE, AND REPAIR OF SIGNAL AND TRAIN CONTROL SYSTEMS, DEVICES, AND APPLIANCES Automatic Train Stop, Train Control and Cab Signal Systems Standards... all conditions of speed, weather, wear, oscillation, and shock. ...

Standards for Endovascular Neurosurgical Training and Certification of the Society of Korean Endovascular Neurosurgeons 2013

PubMed Central

Shin, Dong-Seong; Park, Sukh-Que; Kang, Hyun-Seung; Yoon, Seok-Mann; Cho, Jae-Hoon; Lim, Dong-Jun; Baik, Min-Woo; Kwon, O Ki

2014-01-01

The need for standard endovascular neurosurgical (ENS) training programs and certification in Korea cannot be overlooked due to the increasing number of ENS specialists and the expanding ENS field. The Society of Korean Endovascular Neurosurgeons (SKEN) Certification Committee has prepared training programs and certification since 2010, and the first certificates were issued in 2013. A task force team (TFT) was organized in August 2010 to develop training programs and certification. TFT members researched programs and systems in other countries to develop a program that best suited Korea. After 2 years, a rough draft of the ENS training and certification regulations were prepared, and the standard training program title was decided. The SKEN Certification Committee made an official announcement about the certification program in March 2013. The final certification regulations comprised three major parts: certified endovascular neurosurgeons (EN), certified ENS institutions, and certified ENS training institutions. Applications have been evaluated and the results were announced in June 2013 as follows: 126 members received EN certification and 55 hospitals became ENS-certified institutions. The SKEN has established standard ENS training programs together with a certification system, and it is expected that they will advance the field of ENS to enhance public health and safety in Korea. PMID:24851145

Development, validation and operating room-transfer of a six-step laparoscopic training program for the vesicourethral anastomosis.

PubMed

Klein, Jan; Teber, Dogu; Frede, Tom; Stock, Christian; Hruza, Marcel; Gözen, Ali; Seemann, Othmar; Schulze, Michael; Rassweiler, Jens

2013-03-01

Development and full validation of a laparoscopic training program for stepwise learning of a reproducible application of a standardized laparoscopic anastomosis technique and integration into the clinical course. The training of vesicourethral anastomosis (VUA) was divided into six simple standardized steps. To fix the objective criteria, four experienced surgeons performed the stepwise training protocol. Thirty-eight participants with no previous laparoscopic experience were investigated in their training performance. The times needed to manage each training step and the total training time were recorded. The integration into the clinical course was investigated. The training results and the corresponding steps during laparoscopic radical prostatectomy (LRP) were analyzed. Data analysis of corresponding operating room (OR) sections of 793 LRP was performed. Based on the validity, criteria were determined. In the laboratory section, a significant reduction of OR time for every step was seen in all participants. Coordination: 62%; longitudinal incision: 52%; inverted U-shape incision: 43%; plexus: 47%. Anastomosis catheter model: 38%. VUA: 38%. The laboratory section required a total time of 29 hours (minimum: 16 hours; maximum: 42 hours). All participants had shorter execution times in the laboratory than under real conditions. The best match was found within the VUA model. To perform an anastomosis under real conditions, 25% more time was needed. By using the training protocol, the performance of the VUA is comparable to that of an surgeon with experience of about 50 laparoscopic VUA. Data analysis proved content, construct, and prognostic validity. The use of stepwise training approaches enables a surgeon to learn and reproduce complex reconstructive surgical tasks: eg, the VUA in a safe environment. The validity of the designed system is given at all levels and should be used as a standard in the clinical surgical training in laparoscopic reconstructive urology.

International standards for programmes of training in intensive care medicine in Europe.

PubMed

2011-03-01

To develop internationally harmonised standards for programmes of training in intensive care medicine (ICM). Standards were developed by using consensus techniques. A nine-member nominal group of European intensive care experts developed a preliminary set of standards. These were revised and refined through a modified Delphi process involving 28 European national coordinators representing national training organisations using a combination of moderated discussion meetings, email, and a Web-based tool for determining the level of agreement with each proposed standard, and whether the standard could be achieved in the respondent's country. The nominal group developed an initial set of 52 possible standards which underwent four iterations to achieve maximal consensus. All national coordinators approved a final set of 29 standards in four domains: training centres, training programmes, selection of trainees, and trainers' profiles. Only three standards were considered immediately achievable by all countries, demonstrating a willingness to aspire to quality rather than merely setting a minimum level. Nine proposed standards which did not achieve full consensus were identified as potential candidates for future review. This preliminary set of clearly defined and agreed standards provides a transparent framework for assuring the quality of training programmes, and a foundation for international harmonisation and quality improvement of training in ICM.

A randomized clinical trial in preterm infants on the effects of a home-based early intervention with the 'CareToy System'

PubMed Central

Sgandurra, Giuseppina; Lorentzen, Jakob; Inguaggiato, Emanuela; Bartalena, Laura; Beani, Elena; Cecchi, Francesca; Dario, Paolo; Giampietri, Matteo; Greisen, Gorm; Herskind, Anna; Nielsen, Jens Bo; Rossi, Giuseppe; Cioni, Giovanni

2017-01-01

CareToy system is an innovative tele-rehabilitative tool, useful in providing intensive, individualized, home-based, family-centred Early Intervention (EI) in infants. Our aim was to evaluate, through a Randomized Clinical Trial (RCT) study, the effects of CareToy intervention on early motor and visual development in preterm infants. 41 preterm infants (range age: 3.0–5.9 months of corrected age) were enrolled and randomized into two groups, CareToy and Standard Care. 19 infants randomized in CareToy group performed a 4-week CareToy program, while 22 allocated to control group completed 4 weeks of Standard Care. Infant Motor Profile (IMP) was primary outcome measure, Alberta Infant Motor Scale (AIMS) and Teller Acuity Cards were secondary ones. Assessments were carried out at baseline (T0) and at the end of CareToy training or Standard Care period (T1). T1 was the primary endpoint. After RCT phase, 17 infants from control group carried out a 4-week CareToy program, while 18 infants from the CareToy group continued with Standard Care. At the end of this phase, infants were re-assessed at T2. In RCT phase, delta IMP total score and variation and performance sub-domains were significantly higher (P<0.050) in CareToy group if compared to Standard Care group. Similar results were found for Teller Acuity Cards, while no differences between groups were found for AIMS. No differences were found in any outcome measure results (T2-T0), between infants who started CareToy training before or after one month of standard care. This RCT study confirms the results of a previous pilot study, indicating that CareToy system can provide effective home-based EI. Trial Registration: This trial has been registered at www.clinicaltrials.gov (Identifier NCT01990183). PMID:28328946

49 CFR 236.512 - Cab signal indication when locomotive enters block where restrictive conditions obtain.

Code of Federal Regulations, 2011 CFR

2011-10-01

... TRAIN CONTROL SYSTEMS, DEVICES, AND APPLIANCES Automatic Train Stop, Train Control and Cab Signal Systems Standards § 236.512 Cab signal indication when locomotive enters block where restrictive conditions obtain. The automatic cab signal system shall be arranged so that when a locomotive enters or is...

Micro-Feedback Training:Learning the art of effective feedback

PubMed Central

Baseer, Najma; Mahboob, Usman; Degnan, James

2017-01-01

Multiple attributes are expected of postgraduate research supervisors. Provision of timely and effective face-to-face feedback is one such skill that carries enormous significance in supervisee’s professional development. Feedback allows the supervisees to improve upon their performances. Unfortunately, both supervisors and supervisees have contrasting approaches towards the ongoing feedback practices. This incongruence is attributed, in part, to a lack of structured pedagogic training among the medical professionals. A standardized schema is therefore required to acquire and harmonize this pedagogical skill. One such systemized way is a training method called microteaching. Microteaching has long been used to enhance and incorporate old and new undergraduate teaching skills, respectively. Here we propose a similar structured approach of micro-feedback to inculcate effective feedback skills among postgraduate research supervisors using feedback-based scenarios, simulated students, standardized checklists and audiovisual aids. Thus, micro-feedback exercise may prove to be quite promising in improving feedback practices of postgraduate research supervisors. PMID:29492091

Differentiation of Effect Across Systemic Literacy Programs in Rwanda, the Philippines, and Senegal.

PubMed

Christina, Rachel; Vinogradova, Elena

2017-03-01

In this article, we compare three localized applications (in Rwanda, Senegal, and the Philippines) of a literacy approach for resource-lean environments and examine the factors influencing its impact in each context, considering dosage, duration, and environment. In Rwanda, a bilingual early grade literacy initiative implemented in partnership with the ministry of education included literacy standards development, training for early grade teachers, materials development, leadership support, and community-based activities. In the Philippines, a primary grades trilingual curriculum was implemented in close collaboration with the Department of Education to strengthen its literacy component through standards development, teacher and school leader training, materials development, and awareness campaigns. Finally, in Senegal, a program was conducted supporting the YMCA's efforts to improve local educational outcomes by training youth volunteers to mentor students at risk and by engaging families and communities. © 2017 Wiley Periodicals, Inc.

Orientation and mobility training for adults with low vision: a new standardized approach

PubMed Central

Ballemans, Judith; Kempen, Gertrudis IJM

2013-01-01

Background: Orientation and mobility training aims to facilitate independent functioning and participation in the community of people with low vision. Objective: (1) To gain insight into current practice regarding orientation and mobility training, and (2) to develop a theory-driven standardized version of this training to teach people with low vision how to orientate and be safe in terms of mobility. Study of current practice: Insight into current practice and its strengths and weaknesses was obtained via reviewing the literature, observing orientation and mobility training sessions (n = 5) and interviewing Dutch mobility trainers (n = 18). Current practice was mainly characterized by an individual, face-to-face orientation and mobility training session concerning three components: crystallizing client’s needs, providing information and training skills. A weakness was the lack of a (structured) protocol based on evidence or theory. New theory-driven training: A new training protocol comprising two face-to-face sessions and one telephone follow-up was developed. Its content is partly based on the components of current practice, yet techniques from theoretical frameworks (e.g. social-cognitive theory and self-management) are incorporated. Discussion: A standardized, tailor-made orientation and mobility training for using the identification cane is available. The new theory-driven standardized training is generally applicable for teaching the use of every low-vision device. Its acceptability and effectiveness are currently being evaluated in a randomized controlled trial. PMID:22734105

49 CFR 236.401 - Automatic block signal system and interlocking standards applicable to traffic control systems.

Code of Federal Regulations, 2011 CFR

2011-10-01

... TRAIN CONTROL SYSTEMS, DEVICES, AND APPLIANCES Traffic Control Systems Standards § 236.401 Automatic... 49 Transportation 4 2011-10-01 2011-10-01 false Automatic block signal system and interlocking standards applicable to traffic control systems. 236.401 Section 236.401 Transportation Other Regulations...

Restructuring an undergraduate dental curriculum to global standards--a case study in an Indian dental school.

PubMed

Kadagad, P; Tekian, A; Pinto, P X; Jirge, V L

2012-05-01

Globalisation has affected all aspects of life and dentistry is no exception. In the context of today's dentist being a global citizen, undergraduate training in dentistry is set to ensure converging standards so that international recognition of dental qualifications can move forward. The decision of the Dental Council of India to expand the undergraduate dental program to five years provides an opportunity to be part of the endeavor of the Global Dental Congress to achieve converging standards which was initially for the European Union, and now spreading out globally. Economic emergence in Indian subcontinent has resulted in growing oral health care needs both in quality and quantity. To address this issue, the graduating dentist needs to be trained following a competency based curricular model. Access to Internet facilitated the goal of achieving converging standards of dental schools to be feasible because of the instant communication and capacity to share information about training strategies via technology across the globe. Upgrading the undergraduate training to global standards by dental schools in India could be a wise and strategic move both for attracting students to study in India, as well as retaining the graduates after their training. The following is a case study of an Indian dental school set to restructure the undergraduate curriculum to global standards using the 8 steps of Kotter's transformational change. Change in curriculum and the subsequent accreditation of the school in global platform not only attracts prospective students but also results in producing competent dentists. Dental education provided by the institution can result in quality assurance, benchmarking the assessment system to achieve international recognition. This paper highlights the need and importance of facilitation of international convergence with long term aspirations for mutual recognition of international degrees. © 2011 John Wiley & Sons A/S.

Ride comfort analysis with physiological parameters for an e-health train.

PubMed

Lee, Youngbum; Shin, Kwangsoo; Lee, Sangjoon; Song, Yongsoo; Han, Sungho; Lee, Myoungho

2009-12-01

Transportation by train has numerous advantages over road transportation, especially with regard to energy efficiency, ecological features, safety, and punctuality. However, the contrast in ride comfort between standard road transportation and train travel has become a competitive issue. The ride comfort enhancement technology of tilting trains (TTX) is a particularly important issue in the development of the Korean high-speed railroad business. Ride comfort is now defined in international standards such as UIC13 and ISO2631. The Korean standards such as KSR9216 mainly address physical parameters such as vibration and noise. In the area of ride comfort, living quality parameter techniques have recently been considered in Korea, Japan, and Europe. This study introduces biological parameters, particularly variations in heart rate, as a more direct measure of comfort. Biological parameters are based on physiological responses rather than on purely external mechanical parameters. Variability of heart rate and other physiological parameters of passengers are measured in a simulation involving changes in the tilting angle of the TTX. This research is a preliminary study for the implementation of an e-health train, which would provide passengers with optimized ride comfort. The e-health train would also provide feedback on altered ride comfort situations that can improve a passenger's experience and provide a healthcare service on the train. The aim of this research was to develop a ride comfort evaluation system for the railway industry, the automobile industry, and the air industry. The degree of tilt correlated with heart rate, fatigue, and unrelieved alertness.

Incorporating injured employee outcomes into physical and occupational therapists' practice: a controlled trial of the Worker-Based Outcomes Assessment System.

PubMed

Ross, Robert H; Callas, Peter W; Sargent, Jesse Q; Amick, Benjamin C; Rooney, Ted

2006-12-01

Work related musculoskeletal disorders (WRMSDs) remain costly. The Worker-Based Outcomes Assessment System (WBOAS) is an injury treatment improvement tool. Its purpose is to increase treatment effectiveness and decrease the cost of care delivered in Occupational Health Service clinics. The study used a non-randomized (parallel cohort) control trial design to test the effects on injured employee outcomes of augmenting the standard care delivered by physical and occupational therapists (PT/OTs) with the WBOAS. The WBOAS works by putting patient-reported functional health status, pain symptom, and work role performance outcomes data into the hands of PT/OTs and their patients. Test clinic therapists were trained to incorporate WBOAS trends data into standard practice. Control clinic therapists delivered standard care alone. WBOAS-augmented PT/OT care did improve (p< or =.05) physical functioning and new injury/re-injury avoidance and, on these same dimensions, cost-adjusted outcome. It did not improve (p>.05) mental health or pain symptoms or return-to-work or stay-at-work success nor, on these same dimensions, cost-adjusted outcome. Training PT/OTs to incorporate patient-reported health status, pain symptom, and work role performance outcomes trends data into standard practice does appear to improve treatment effectiveness and cost on some (e.g. physical functioning) but not other (e.g. mental health, pain symptoms) outcomes.

Improving operating room safety

PubMed Central

2009-01-01

Despite the introduction of the Universal Protocol, patient safety in surgery remains a daily challenge in the operating room. This present study describes one community health system's efforts to improve operating room safety through human factors training and ultimately the development of a surgical checklist. Using a combination of formal training, local studies documenting operating room safety issues and peer to peer mentoring we were able to substantially change the culture of our operating room. Our efforts have prepared us for successfully implementing a standardized checklist to improve operating room safety throughout our entire system. Based on these findings we recommend a multimodal approach to improving operating room safety. PMID:19930577

Radiation dose reduction in digital breast tomosynthesis (DBT) by means of deep-learning-based supervised image processing

NASA Astrophysics Data System (ADS)

Liu, Junchi; Zarshenas, Amin; Qadir, Ammar; Wei, Zheng; Yang, Limin; Fajardo, Laurie; Suzuki, Kenji

2018-03-01

To reduce cumulative radiation exposure and lifetime risks for radiation-induced cancer from breast cancer screening, we developed a deep-learning-based supervised image-processing technique called neural network convolution (NNC) for radiation dose reduction in DBT. NNC employed patched-based neural network regression in a convolutional manner to convert lower-dose (LD) to higher-dose (HD) tomosynthesis images. We trained our NNC with quarter-dose (25% of the standard dose: 12 mAs at 32 kVp) raw projection images and corresponding "teaching" higher-dose (HD) images (200% of the standard dose: 99 mAs at 32 kVp) of a breast cadaver phantom acquired with a DBT system (Selenia Dimensions, Hologic, CA). Once trained, NNC no longer requires HD images. It converts new LD images to images that look like HD images; thus the term "virtual" HD (VHD) images. We reconstructed tomosynthesis slices on a research DBT system. To determine a dose reduction rate, we acquired 4 studies of another test phantom at 4 different radiation doses (1.35, 2.7, 4.04, and 5.39 mGy entrance dose). Structural SIMilarity (SSIM) index was used to evaluate the image quality. For testing, we collected half-dose (50% of the standard dose: 32+/-14 mAs at 33+/-5 kVp) and full-dose (standard dose: 68+/-23 mAs at 33+/-5 kvp) images of 10 clinical cases with the DBT system at University of Iowa Hospitals and Clinics. NNC converted half-dose DBT images of 10 clinical cases to VHD DBT images that were equivalent to full dose DBT images. Our cadaver phantom experiment demonstrated 79% dose reduction.

An easy-to-build, low-budget point-of-care ultrasound simulator: from Linux to a web-based solution.

PubMed

Damjanovic, Domagoj; Goebel, Ulrich; Fischer, Benedikt; Huth, Martin; Breger, Hartmut; Buerkle, Hartmut; Schmutz, Axel

2017-12-01

Hands-on training in point-of-care ultrasound (POC-US) should ideally comprise bedside teaching, as well as simulated clinical scenarios. High-fidelity phantoms and portable ultrasound simulation systems are commercially available, however, at considerable costs. This limits their suitability for medical schools. A Linux-based software for Emergency Department Ultrasound Simulation (edus2TM) was developed by Kulyk and Olszynski in 2011. Its feasibility for POC-US education has been well-documented, and shows good acceptance. An important limitation to an even more widespread use of edus2, however, may be due to the need for a virtual machine for WINDOWS ® systems. Our aim was to adapt the original software toward an HTML-based solution, thus making it affordable and applicable in any simulation setting. We created an HTML browser-based ultrasound simulation application, which reads the input of different sensors, triggering an ultrasound video to be displayed on a respective device. RFID tags, NFC tags, and QR Codes™ have been integrated into training phantoms or were attached to standardized patients. The RFID antenna was hidden in a mock ultrasound probe. The application is independent from the respective device. Our application was used successfully with different trigger/scanner combinations and mounted readily into simulated training scenarios. The application runs independently from operating systems or electronic devices. This low-cost, browser-based ultrasound simulator is easy-to-build, very adaptive, and independent from operating systems. It has the potential to facilitate POC-US training throughout the world, especially in resource-limited areas.

Getting It Right the First Time: Defining Regionally Relevant Training Curricula and Provider Core Competencies for Point-of-Care Ultrasound Education on the African Continent.

PubMed

Salmon, Margaret; Landes, Megan; Hunchak, Cheryl; Paluku, Justin; Malemo Kalisya, Luc; Salmon, Christian; Muller, Mundenga Mutendi; Wachira, Benjamin; Mangan, James; Chhaganlal, Kajal; Kalanzi, Joseph; Azazh, Aklilu; Berman, Sara; Zied, El-Sayed; Lamprecht, Hein

2017-02-01

Significant evidence identifies point-of-care ultrasound (PoCUS) as an important diagnostic and therapeutic tool in resource-limited settings. Despite this evidence, local health care providers on the African continent continue to have limited access to and use of ultrasound, even in potentially high-impact fields such as obstetrics and trauma. Dedicated postgraduate emergency medicine residency training programs now exist in 8 countries, yet no current consensus exists in regard to core PoCUS competencies. The current practice of transferring resource-rich PoCUS curricula and delivery methods to resource-limited health systems fails to acknowledge the unique challenges, needs, and disease burdens of recipient systems. As emergency medicine leaders from 8 African countries, we introduce a practical algorithmic approach, based on the local epidemiology and resource constraints, to curriculum development and implementation. We describe an organizational structure composed of nexus learning centers for PoCUS learners and champions on the continent to keep credentialing rigorous and standardized. Finally, we put forth 5 key strategic considerations: to link training programs to hospital systems, to prioritize longitudinal learning models, to share resources to promote health equity, to maximize access, and to develop a regional consensus on training standards and credentialing. Copyright © 2016 American College of Emergency Physicians. Published by Elsevier Inc. All rights reserved.

[Rehabilitation in undergraduate education and advanced professional training of the participating professional groups].

PubMed

Mau, Wilfried; Bengel, Jürgen; Pfeifer, Klaus

2017-04-01

In the German health care system, multiprofessional and coordinated rehabilitation care provides support for successful disease management. Against a background of the conditions and strong dynamics of the provision, this article gives an overview of some of the pertinent developments in rehabilitation-related undergraduate education and advanced professional training of physicians, psychologists, and exercise therapy professions in Germany. Frequently, there are few provisions and great variation between different locations. New conditions, such as the National Competence-Based Learning Objectives for Undergraduate Medical Education, the National Guidelines for Graduate Medical Education, and the ongoing reform of the psychotherapists' law emphasizing training in psychotherapy at university, allow the expectation of a positive effect on the competence of rehabilitation professionals. Education in physiotherapy is developing according to international standards aimed at improved evidence-based care. For the widely evidence-based undergraduate education and advanced professional training in sports and exercise therapy better profiling and professionalization should be sought.

Lunar and Planetary Science XXXV: Engaging K-12 Educators, Students, and the General Public in Space Science Exploration

NASA Technical Reports Server (NTRS)

2004-01-01

The session "Engaging K-12 Educators, Students, and the General Public in Space Science Exploration" included the following reports:Training Informal Educators Provides Leverage for Space Science Education and Public Outreach; Teacher Leaders in Research Based Science Education: K-12 Teacher Retention, Renewal, and Involvement in Professional Science; Telling the Tale of Two Deserts: Teacher Training and Utilization of a New Standards-based, Bilingual E/PO Product; Lindstrom M. M. Tobola K. W. Stocco K. Henry M. Allen J. S. McReynolds J. Porter T. T. Veile J. Space Rocks Tell Their Secrets: Space Science Applications of Physics and Chemistry for High School and College Classes -- Update; Utilizing Mars Data in Education: Delivering Standards-based Content by Exposing Educators and Students to Authentic Scientific Opportunities and Curriculum; K. E. Little Elementary School and the Young Astronaut Robotics Program; Integrated Solar System Exploration Education and Public Outreach: Theme, Products and Activities; and Online Access to the NEAR Image Collection: A Resource for Educators and Scientists.

Paving the road for a European postgraduate training curriculum.

PubMed

van der Aa, Jessica E; Goverde, Angelique J; Teunissen, Pim W; Scheele, Fedde

2016-08-01

The 'Project for Achieving Consensus in Training' has been initiated by the European Board & College of Obstetrics and Gynaecology to harmonise training in Obstetrics and Gynaecology throughout Europe. In this project called the EBCOG-PACT, a state of the art pan-European training curriculum will be developed. Implementation of a pan-European curriculum will enhance harmonisation of both quality standards of women's healthcare practice and standards of postgraduate training. Secondly, it will assure equal quality of training of gynaecologists, promoting mobility throughout Europe. Thirdly, it will enhance cooperation and exchange of best practices between medical specialists and hospitals within Europe. The project is expecting to deliver (1) a description of the core and electives of the curriculum based on previously defined standards of care, (2) a societally responsive competency framework based on input from societal stakeholders and (3) strategies for education and assessment based on the current literature. Also, the project focuses on implementation and sustainability of the curriculum by delivering (4) a SWOT-analysis for the implementation based on insights into transcultural differences, (5) recommendations for implementation, change management and sustainability based on the SWOT analysis (6) and finally a handbook for other specialties initiating European curriculum development. The development and the implementation of this modern pan-European curriculum in Obstetrics and Gynaecology aims to serve as an example for the harmonisation of postgraduate training in Europe. Copyright © 2016. Published by Elsevier Ireland Ltd.

Skills Standards, British Style. Linking Assessment and Training in the United Kingdom. NOICC Occasional Paper 6.

ERIC Educational Resources Information Center

Newton, Wendy M.

A major review of vocational education and training has occurred across the United Kingdom since 1986. Employment requirements are being identified in the form of occupational standards that provide the foundation for the new system of vocational qualifications, National Vocational Qualifications (NVQs). Standards describe what people need to be…

Training in Basic Laparoscopic Surgical Skills: Residents Opinion of the New Nintendo Wii-U Laparoscopic Simulator.

PubMed

Overtoom, Evelien M; Jansen, Frank-Willem; van Santbrink, Evert J P; Schraffordt Koops, Steven E; Veersema, Sebastiaan; Schreuder, Henk W R

Serious games are new in the field of laparoscopic surgical training. We evaluate the residents׳ opinion of a new laparoscopic simulator for the Nintendo Wii-U platform. Prospective questionnaire study. Participants received a standardized introduction and completed level 3 and 4 of the game "Underground." They filled out a questionnaire concerning demographics and their opinion on realism, usefulness, suitability, haptic feedback, and home training-use of the game. Two tertiary teaching hospitals. Obstetrics and gynaecology residents postgraduate year 1 to 6 (n = 59) from several European countries. Subjects (n = 59) were divided into 2 groups based on laparoscopic experience: Group A (n = 38) and Group B (n = 21). The realism of different aspects of the game received mean scores around 3 on a 5-point Likert scale. The hand-eye coordination was regarded most useful for training with a mean of 3.92 (standard deviation 0.93) and the game was considered most suitable for residents in the first part of their postgraduate training with a mean of 3.73 (standard deviation 0.97). Both groups differed especially concerning their opinion of the usefulness of the game as a training tool. Most residents liked the new serious game for the Nintendo Wii-U. The usefulness and suitability as a laparoscopic training tool were rated at an acceptable to high level. However, the game does require improvements such as inclusion of a good scoring system before it can be integrated in resident training curricula. Copyright © 2017 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

Safety of clinical and non-clinical decision makers in telephone triage: a narrative review.

PubMed

Wheeler, Sheila Q; Greenberg, Mary E; Mahlmeister, Laura; Wolfe, Nicole

2015-09-01

Patient safety is a persistent problem in telephone triage research; however, studies have not differentiated between clinicians' and non-clinicians' respective safety. Currently, four groups of decision makers perform aspects of telephone triage: clinicians (physicians, nurses), and non-clinicians (emergency medical dispatchers (EMD) and clerical staff). Using studies published between 2002-2012, we applied Donabedian's structure-process-outcome model to examine groups' systems for evidence of system completeness (a minimum measure of structure and quality). We defined system completeness as the presence of a decision maker and four additional components: guidelines, documentation, training, and standards. Defining safety as appropriate referrals (AR) - (right time, right place with the right person), we measured each groups' corresponding AR rate percentages (outcomes). We analyzed each group's respective decision-making process as a safe match to the telephone triage task, based on each group's system structure completeness, process and AR rates (outcome). Studies uniformly noted system component presence: nurses (2-4), physicians (1), EMDs (2), clerical staff (1). Nurses had the highest average appropriate referral (AR) rates (91%), physicians' AR (82% average). Clerical staff had no system and did not perform telephone triage by standard definitions; EMDs may represent the use of the wrong system. Telephone triage appears least safe after hours when decision makers with the least complete systems (physicians, clerical staff) typically manage calls. At minimum, telephone triage decision makers should be clinicians; however, clinicians' safety calls for improvement. With improved training, standards and CDSS quality, the 24/7 clinical call center has potential to represent the national standard. © The Author(s) 2015.

Using Standardized Clients to Train Social Workers in Intimate Partner Violence Assessment

ERIC Educational Resources Information Center

Forgey, Mary Ann; Badger, Lee; Gilbert, Tracey; Hansen, Johna

2013-01-01

Evidence-based assessment in intimate partner violence (IPV) is critical to the accurate understanding of risk and to the development of interventions that increase safety. In this study standardized clients (actors) were used to train Army civilian social workers in evidence-based assessment of IPV and in the evaluation of the curriculum's…

Empiric determination of corrected visual acuity standards for train crews.

PubMed

Schwartz, Steven H; Swanson, William H

2005-08-01

Probably the most common visual standard for employment in the transportation industry is best-corrected, high-contrast visual acuity. Because such standards were often established absent empiric linkage to job performance, it is possible that a job applicant or employee who has visual acuity less than the standard may be able to satisfactorily perform the required job activities. For the transportation system that we examined, the train crew is required to inspect visually the length of the train before and during the time it leaves the station. The purpose of the inspection is to determine if an individual is in a hazardous position with respect to the train. In this article, we determine the extent to which high-contrast visual acuity can predict performance on a simulated task. Performance at discriminating hazardous from safe conditions, as depicted in projected photographic slides, was determined as a function of visual acuity. For different levels of visual acuity, which was varied through the use of optical defocus, a subject was required to label scenes as hazardous or safe. Task performance was highly correlated with visual acuity as measured under conditions normally used for vision screenings (high-illumination and high-contrast): as the acuity decreases, performance at discriminating hazardous from safe scenes worsens. This empirically based methodology can be used to establish a corrected high-contrast visual acuity standard for safety-sensitive work in transportation that is linked to the performance of a job-critical task.

Standardization of Clinical Skill Evaluation in Physical/Occupational Therapist Education –Effects of Introduction of an Education System Using OSCE–

PubMed Central

Sakurai, Hiroaki; Kanada, Yoshikiyo; Sugiura, Yoshito; Motoya, Ikuo; Yamada, Masayuki; Tomita, Masao; Naka, Toru; Teranishi, Toshio; Tanabe, Shigeo; Tsujimura, Toru; Okanishi, Tetsuo

2013-01-01

[Purpose] A major issue in physical/occupational therapist education is the improvement of students' clinical techniques. In this study, we introduced an education system using an Objective Structured Clinical Examination (OSCE), and made an attempt at standardization of its evaluation. [Subjects] The subjects were 227 students in the classes of 2008 to 2010 who enrolled at our university between 2004 and 2006, before the introduction of the education system using OSCE, and 221 students in the classes of 2011 to 2013 who enrolled between 2007 and 2009, after the introduction. [Methods] Performances in attitude and skills (performance in clinical training and OSCE) were compared between before and after the introduction of OSCE. OSCE results were compared between before and after clinical trainings at each OSCE Level; and the correlation of between performances in clinical training and OSCE was examined. [Results] Performances in OSCE and clinical training (attitude, skills) were improved by the introduction of the education system using OSCE, but no significant correlation was observed in the relationship between performances in OSCE and clinical training. [Conclusion] Further studies should be conducted aiming at the standardization of clinical skill evaluation in postgraduate education to establish an education system using OSCE. PMID:24259918

Effects of frequency discrimination training on tinnitus: results from two randomised controlled trials.

PubMed

Hoare, Derek J; Kowalkowski, Victoria L; Hall, Deborah A

2012-08-01

That auditory perceptual training may alleviate tinnitus draws on two observations: (1) tinnitus probably arises from altered activity within the central auditory system following hearing loss and (2) sound-based training can change central auditory activity. Training that provides sound enrichment across hearing loss frequencies has therefore been hypothesised to alleviate tinnitus. We tested this prediction with two randomised trials of frequency discrimination training involving a total of 70 participants with chronic subjective tinnitus. Participants trained on either (1) a pure-tone standard at a frequency within their region of normal hearing, (2) a pure-tone standard within the region of hearing loss or (3) a high-pass harmonic complex tone spanning a region of hearing loss. Analysis of the primary outcome measure revealed an overall reduction in self-reported tinnitus handicap after training that was maintained at a 1-month follow-up assessment, but there were no significant differences between groups. Secondary analyses also report the effects of different domains of tinnitus handicap on the psychoacoustical characteristics of the tinnitus percept (sensation level, bandwidth and pitch) and on duration of training. Our overall findings and conclusions cast doubt on the superiority of a purely acoustic mechanism to underpin tinnitus remediation. Rather, the nonspecific patterns of improvement are more suggestive that auditory perceptual training affects impact on a contributory mechanism such as selective attention or emotional state.

Systems and technologies for objective evaluation of technical skills in laparoscopic surgery.

PubMed

Sánchez-Margallo, Juan A; Sánchez-Margallo, Francisco M; Oropesa, Ignacio; Gómez, Enrique J

2014-01-01

Minimally invasive surgery is a highly demanding surgical approach regarding technical requirements for the surgeon, who must be trained in order to perform a safe surgical intervention. Traditional surgical education in minimally invasive surgery is commonly based on subjective criteria to quantify and evaluate surgical abilities, which could be potentially unsafe for the patient. Authors, surgeons and associations are increasingly demanding the development of more objective assessment tools that can accredit surgeons as technically competent. This paper describes the state of the art in objective assessment methods of surgical skills. It gives an overview on assessment systems based on structured checklists and rating scales, surgical simulators, and instrument motion analysis. As a future work, an objective and automatic assessment method of surgical skills should be standardized as a means towards proficiency-based curricula for training in laparoscopic surgery and its certification.

49 CFR 213.347 - Automotive or railroad crossings at grade.

Code of Federal Regulations, 2010 CFR

2010-10-01

... ADMINISTRATION, DEPARTMENT OF TRANSPORTATION TRACK SAFETY STANDARDS Train Operations at Track Classes 6 and.../barrier system to address the protection of highway traffic and high speed trains. Trains shall not...-approved warning/barrier system exists on that track segment; and (2) All elements of that warning/barrier...

49 CFR 236.515 - Visibility of cab signals.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 49 Transportation 4 2010-10-01 2010-10-01 false Visibility of cab signals. 236.515 Section 236.515..., MAINTENANCE, AND REPAIR OF SIGNAL AND TRAIN CONTROL SYSTEMS, DEVICES, AND APPLIANCES Automatic Train Stop, Train Control and Cab Signal Systems Standards § 236.515 Visibility of cab signals. The cab signals...

49 CFR 236.515 - Visibility of cab signals.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 49 Transportation 4 2011-10-01 2011-10-01 false Visibility of cab signals. 236.515 Section 236.515..., MAINTENANCE, AND REPAIR OF SIGNAL AND TRAIN CONTROL SYSTEMS, DEVICES, AND APPLIANCES Automatic Train Stop, Train Control and Cab Signal Systems Standards § 236.515 Visibility of cab signals. The cab signals...

49 CFR 236.515 - Visibility of cab signals.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 49 Transportation 4 2014-10-01 2014-10-01 false Visibility of cab signals. 236.515 Section 236.515..., MAINTENANCE, AND REPAIR OF SIGNAL AND TRAIN CONTROL SYSTEMS, DEVICES, AND APPLIANCES Automatic Train Stop, Train Control and Cab Signal Systems Standards § 236.515 Visibility of cab signals. The cab signals...

49 CFR 236.515 - Visibility of cab signals.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 49 Transportation 4 2012-10-01 2012-10-01 false Visibility of cab signals. 236.515 Section 236.515..., MAINTENANCE, AND REPAIR OF SIGNAL AND TRAIN CONTROL SYSTEMS, DEVICES, AND APPLIANCES Automatic Train Stop, Train Control and Cab Signal Systems Standards § 236.515 Visibility of cab signals. The cab signals...

49 CFR 236.515 - Visibility of cab signals.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 49 Transportation 4 2013-10-01 2013-10-01 false Visibility of cab signals. 236.515 Section 236.515..., MAINTENANCE, AND REPAIR OF SIGNAL AND TRAIN CONTROL SYSTEMS, DEVICES, AND APPLIANCES Automatic Train Stop, Train Control and Cab Signal Systems Standards § 236.515 Visibility of cab signals. The cab signals...

49 CFR 193.2719 - Training: records.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 49 Transportation 3 2010-10-01 2010-10-01 false Training: records. 193.2719 Section 193.2719...: FEDERAL SAFETY STANDARDS Personnel Qualifications and Training § 193.2719 Training: records. (a) Each operator shall maintain a system of records which— (1) Provide evidence that the training programs required...

49 CFR 193.2719 - Training: records.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 49 Transportation 3 2011-10-01 2011-10-01 false Training: records. 193.2719 Section 193.2719...: FEDERAL SAFETY STANDARDS Personnel Qualifications and Training § 193.2719 Training: records. (a) Each operator shall maintain a system of records which— (1) Provide evidence that the training programs required...

Assessment of a Tele-education System to Enhance Retinopathy of Prematurity Training by International Ophthalmologists-in-Training in Mexico.

PubMed

Patel, Samir N; Martinez-Castellanos, Maria Ana; Berrones-Medina, David; Swan, Ryan; Ryan, Michael C; Jonas, Karyn E; Ostmo, Susan; Campbell, J Peter; Chiang, Michael F; Chan, R V Paul

2017-07-01

To evaluate a tele-education system developed to improve diagnostic competency in retinopathy of prematurity (ROP) by ophthalmologists-in-training in Mexico. Prospective, randomized cohort study. Fifty-eight ophthalmology residents and fellows from a training program in Mexico consented to participate. Twenty-nine of 58 trainees (50%) were randomized to the educational intervention (pretest, ROP tutorial, ROP educational chapters, and posttest), and 29 of 58 trainees (50%) were randomized to a control group (pretest and posttest only). A secure web-based educational system was created using clinical cases (20 pretest, 20 posttest, and 25 training chapter-based) developed from a repository of over 2500 unique image sets of ROP. For each image set used, a reference standard ROP diagnosis was established by combining the clinical diagnosis by indirect ophthalmoscope examination and image-based diagnosis by multiple experts. Trainees were presented with image-based clinical cases of ROP during a pretest, posttest, and training chapters. The accuracy of ROP diagnosis (e.g., plus disease, zone, stage, category) was determined using sensitivity and specificity calculations from the pretest and posttest results of the educational intervention group versus control group. The unweighted kappa statistic was used to analyze the intragrader agreement for ROP diagnosis by the ophthalmologists-in-training during the pretest and posttest for both groups. Trainees completing the tele-education system had statistically significant improvements (P < 0.01) in the accuracy of ROP diagnosis for plus disease, zone, stage, category, and aggressive posterior ROP (AP-ROP). Compared with the control group, trainees who completed the ROP tele-education system performed better on the posttest for accurately diagnosing plus disease (67% vs. 48%; P = 0.04) and the presence of ROP (96% vs. 91%; P < 0.01). The specificity for diagnosing AP-ROP (94% vs. 78%; P < 0.01), type 2 ROP or worse (92% vs. 84%; P = 0.04), and ROP requiring treatment (89% vs. 79%; P < 0.01) was better for the trainees completing the tele-education system compared with the control group. Intragrader agreement improved for identification of plus disease, zone, stage, and category of ROP after completion of the educational intervention. A tele-education system for ROP education was effective in improving the diagnostic accuracy of ROP by ophthalmologists-in-training in Mexico. This system has the potential to increase competency in ROP diagnosis and management for ophthalmologists-in-training from middle-income nations. Copyright © 2017 American Academy of Ophthalmology. Published by Elsevier Inc. All rights reserved.

49 CFR 232.601 - Scope.

Code of Federal Regulations, 2010 CFR

2010-10-01

... TRANSPORTATION BRAKE SYSTEM SAFETY STANDARDS FOR FREIGHT AND OTHER NON-PASSENGER TRAINS AND EQUIPMENT; END-OF-TRAIN DEVICES Electronically Controlled Pneumatic (ECP) Braking Systems § 232.601 Scope. This subpart... systems. This subpart also contains specific exceptions from various requirements contained in this part...

A Standardized DNA Variant Scoring System for Pathogenicity Assessments in Mendelian Disorders

PubMed Central

Karbassi, Izabela; Maston, Glenn A.; Love, Angela; DiVincenzo, Christina; Braastad, Corey D.; Elzinga, Christopher D.; Bright, Alison R.; Previte, Domenic; Zhang, Ke; Rowland, Charles M.; McCarthy, Michele; Lapierre, Jennifer L.; Dubois, Felicita; Medeiros, Katelyn A.; Batish, Sat Dev; Jones, Jeffrey; Liaquat, Khalida; Hoffman, Carol A.; Jaremko, Malgorzata; Wang, Zhenyuan; Sun, Weimin; Buller‐Burckle, Arlene; Strom, Charles M.; Keiles, Steven B.

2015-01-01

ABSTRACT We developed a rules‐based scoring system to classify DNA variants into five categories including pathogenic, likely pathogenic, variant of uncertain significance (VUS), likely benign, and benign. Over 16,500 pathogenicity assessments on 11,894 variants from 338 genes were analyzed for pathogenicity based on prediction tools, population frequency, co‐occurrence, segregation, and functional studies collected from internal and external sources. Scores were calculated by trained scientists using a quantitative framework that assigned differential weighting to these five types of data. We performed descriptive and comparative statistics on the dataset and tested interobserver concordance among the trained scientists. Private variants defined as variants found within single families (n = 5,182), were either VUS (80.5%; n = 4,169) or likely pathogenic (19.5%; n = 1,013). The remaining variants (n = 6,712) were VUS (38.4%; n = 2,577) or likely benign/benign (34.7%; n = 2,327) or likely pathogenic/pathogenic (26.9%, n = 1,808). Exact agreement between the trained scientists on the final variant score was 98.5% [95% confidence interval (CI) (98.0, 98.9)] with an interobserver consistency of 97% [95% CI (91.5, 99.4)]. Variant scores were stable and showed increasing odds of being in agreement with new data when re‐evaluated periodically. This carefully curated, standardized variant pathogenicity scoring system provides reliable pathogenicity scores for DNA variants encountered in a clinical laboratory setting. PMID:26467025

A Standardized DNA Variant Scoring System for Pathogenicity Assessments in Mendelian Disorders.

PubMed

Karbassi, Izabela; Maston, Glenn A; Love, Angela; DiVincenzo, Christina; Braastad, Corey D; Elzinga, Christopher D; Bright, Alison R; Previte, Domenic; Zhang, Ke; Rowland, Charles M; McCarthy, Michele; Lapierre, Jennifer L; Dubois, Felicita; Medeiros, Katelyn A; Batish, Sat Dev; Jones, Jeffrey; Liaquat, Khalida; Hoffman, Carol A; Jaremko, Malgorzata; Wang, Zhenyuan; Sun, Weimin; Buller-Burckle, Arlene; Strom, Charles M; Keiles, Steven B; Higgins, Joseph J

2016-01-01

We developed a rules-based scoring system to classify DNA variants into five categories including pathogenic, likely pathogenic, variant of uncertain significance (VUS), likely benign, and benign. Over 16,500 pathogenicity assessments on 11,894 variants from 338 genes were analyzed for pathogenicity based on prediction tools, population frequency, co-occurrence, segregation, and functional studies collected from internal and external sources. Scores were calculated by trained scientists using a quantitative framework that assigned differential weighting to these five types of data. We performed descriptive and comparative statistics on the dataset and tested interobserver concordance among the trained scientists. Private variants defined as variants found within single families (n = 5,182), were either VUS (80.5%; n = 4,169) or likely pathogenic (19.5%; n = 1,013). The remaining variants (n = 6,712) were VUS (38.4%; n = 2,577) or likely benign/benign (34.7%; n = 2,327) or likely pathogenic/pathogenic (26.9%, n = 1,808). Exact agreement between the trained scientists on the final variant score was 98.5% [95% confidence interval (CI) (98.0, 98.9)] with an interobserver consistency of 97% [95% CI (91.5, 99.4)]. Variant scores were stable and showed increasing odds of being in agreement with new data when re-evaluated periodically. This carefully curated, standardized variant pathogenicity scoring system provides reliable pathogenicity scores for DNA variants encountered in a clinical laboratory setting. © 2015 The Authors. **Human Mutation published by Wiley Periodicals, Inc.

Development, implementation, and characterization of a standalone embedded viscosity measurement system based on the impedance spectroscopy of a vibrating wire sensor

NASA Astrophysics Data System (ADS)

Santos, José; Janeiro, Fernando M.; Ramos, Pedro M.

2015-10-01

This paper presents an embedded liquid viscosity measurement system based on a vibrating wire sensor. Although multiple viscometers based on different working principles are commercially available, there is still a market demand for a dedicated measurement system capable of performing accurate, fast measurements and requiring little or no operator training for simple systems and solution monitoring. The developed embedded system is based on a vibrating wire sensor that works by measuring the impedance response of the sensor, which depends on the viscosity and density of the liquid in which the sensor is immersed. The core of the embedded system is a digital signal processor (DSP) which controls the waveform generation and acquisitions for the measurement of the impedance frequency response. The DSP also processes the acquired waveforms and estimates the liquid viscosity. The user can interact with the measurement system through a keypad and an LCD or through a computer with a USB connection for data logging and processing. The presented system is tested on a set of viscosity standards and the estimated values are compared with the standard manufacturer specified viscosity values. A stability study of the measurement system is also performed.

National Apprenticeship and Training Standards for Carpentry. Revised.

ERIC Educational Resources Information Center

Employment and Training Administration (DOL), Washington, DC. Bureau of Apprenticeship and Training.

Designed to guide local organizations of contractors and journeymen in establishing and improving local apprenticeship systems, this booklet contains the latest revision of the National Joint Carpentry Apprenticeship and Training Committee standards pertaining to the basic requirements for effective apprenticeship. In a section on adapting…

A Machine Learning-based Rainfall System for GPM Dual-frequency Radar

NASA Astrophysics Data System (ADS)

Tan, H.; Chandrasekar, V.; Chen, H.

2017-12-01

Precipitation measurement produced by the Global Precipitation Measurement (GPM) Dual-frequency Precipitation Radar (DPR) plays an important role in researching the water circle and forecasting extreme weather event. Compare with its predecessor - Tropical Rainfall Measuring Mission (TRMM) Precipitation Radar (PR), GRM DPR measures precipitation in two different frequencies (i.e., Ku and Ka band), which can provide detailed information on the microphysical properties of precipitation particles, quantify particle size distribution and quantitatively measure light rain and falling snow. This paper presents a novel Machine Learning system for ground-based and space borne radar rainfall estimation. The system first trains ground radar data for rainfall estimation using rainfall measurements from gauges and subsequently uses the ground radar based rainfall estimates to train GPM DPR data in order to get space based rainfall product. Therein, data alignment between space DPR and ground radar is conducted using the methodology proposed by Bolen and Chandrasekar (2013), which can minimize the effects of potential geometric distortion of GPM DPR observations. For demonstration purposes, rainfall measurements from three rain gauge networks near Melbourne, Florida, are used for training and validation purposes. These three gauge networks, which are located in Kennedy Space Center (KSC), South Florida Water Management District (SFL), and St. Johns Water Management District (STJ), include 33, 46, and 99 rain gauge stations, respectively. Collocated ground radar observations from the National Weather Service (NWS) Weather Surveillance Radar - 1988 Doppler (WSR-88D) in Melbourne (i.e., KMLB radar) are trained with the gauge measurements. The trained model is then used to derive KMLB radar based rainfall product, which is used to train GPM DPR data collected from coincident overpasses events. The machine learning based rainfall product is compared against the GPM standard products, which shows great potential of the machine learning concept in radar rainfall estimation.

Automated surface quality inspection with ARGOS: a case study

NASA Astrophysics Data System (ADS)

Kiefhaber, Daniel; Etzold, Fabian; Warken, Arno F.; Asfour, Jean-Michel

2017-06-01

The commercial availability of automated inspection systems for optical surfaces specified according to ISO 10110-7 promises unsupervised and automated quality control with reproducible results. In this study, the classification results of the ARGOS inspection system are compared to the decisions by well-trained inspectors based on manual-visual inspection. Both are found to agree in 93.6% of the studied cases. Exemplary cases with differing results are studied, and shown to be partly caused by shortcomings of the ISO 10110-7 standard, which was written for the industry standard manual-visual inspection. Applying it to high resolution images of the whole surface of objective machine vision systems brings with it a few challenges which are discussed.

The use of standardized patients in the plastic surgery residency curriculum: teaching core competencies with objective structured clinical examinations.

PubMed

Davis, Drew; Lee, Gordon

2011-07-01

As of 2006, the Accreditation Council for Graduate Medical Education had defined six "core competencies" of residency education: interpersonal communication skills, medical knowledge, patient care, professionalism, practice-based learning and improvement, and systems-based practice. Objective structured clinical examinations using standardized patients are becoming effective educational tools, and the authors developed a novel use of the examinations in plastic surgery residency education that assesses all six competencies. Six plastic surgery residents, two each from postgraduate years 4, 5, and 6, participated in the plastic surgery-specific objective structured clinical examination that focused on melanoma. The examination included a 30-minute videotaped encounter with a standardized patient actor and a postencounter written exercise. The residents were scored on their performance in all six core competencies by the standardized patients and faculty experts on a three-point scale (1 = novice, 2 = moderately skilled, and 3 = proficient). Resident performance was averaged for each postgraduate year, stratified according to core competency, and scored from a total of 100 percent. Residents overall scored well in interpersonal communications skills (84 percent), patient care (83 percent), professionalism (86 percent), and practice-based learning (84 percent). Scores in medical knowledge showed a positive correlation with level of training (86 percent). All residents scored comparatively lower in systems-based practice (65 percent). The residents reported unanimously that the objective structured clinical examination was realistic and educational. The objective structured clinical examination provided comprehensive and meaningful feedback and identified areas of strengths and weakness for the residents and for the teaching program. The examination is an effective assessment tool for the core competencies and a valuable adjunct to residency training.

Standards-Based Assessment, Grading, and Reporting in Classrooms: Can District Training and Support Change Teacher Practice?

ERIC Educational Resources Information Center

McMunn, Nancy; Schenck, Patricia; McColskey, Wendy

Whether school district support and training in standards-based assessment, grading, and reporting in classrooms can change teacher practice in these areas was studied in a Florida school district. This district, Bay District Schools of Panama City, has been working with the SERVE Regional Educational Laboratory on a project that involves teachers…

A Random Forest-based ensemble method for activity recognition.

PubMed

Feng, Zengtao; Mo, Lingfei; Li, Meng

2015-01-01

This paper presents a multi-sensor ensemble approach to human physical activity (PA) recognition, using random forest. We designed an ensemble learning algorithm, which integrates several independent Random Forest classifiers based on different sensor feature sets to build a more stable, more accurate and faster classifier for human activity recognition. To evaluate the algorithm, PA data collected from the PAMAP (Physical Activity Monitoring for Aging People), which is a standard, publicly available database, was utilized to train and test. The experimental results show that the algorithm is able to correctly recognize 19 PA types with an accuracy of 93.44%, while the training is faster than others. The ensemble classifier system based on the RF (Random Forest) algorithm can achieve high recognition accuracy and fast calculation.

49 CFR 232.602 - Applicability.

Code of Federal Regulations, 2010 CFR

2010-10-01

..., DEPARTMENT OF TRANSPORTATION BRAKE SYSTEM SAFETY STANDARDS FOR FREIGHT AND OTHER NON-PASSENGER TRAINS AND EQUIPMENT; END-OF-TRAIN DEVICES Electronically Controlled Pneumatic (ECP) Braking Systems § 232.602... this part and equipped with an ECP brake system. Unless specifically excepted or modified in this...

Simulation training in video-assisted urologic surgery.

PubMed

Hoznek, András; Salomon, Laurent; de la Taille, Alexandre; Yiou, René; Vordos, Dimitrios; Larre, Stéphane; Abbou, Clément-Claude

2006-03-01

The current system of surgical education is facing many challenges in terms of time efficiency, costs, and patient safety. Training using simulation is an emerging area, mostly based on the experience of other high-risk professions like aviation. The goal of simulation-based training in surgery is to develop not only technical but team skills. This learning environment is stress-free and safe, allows standardization and tailoring of training, and also objectively evaluate performances. The development of simulation training is straightforward in endourology, since these procedures are video-assisted and the low degree of freedom of the instruments is easily replicated. On the other hand, these interventions necessitate a long learning curve, training in the operative room is especially costly and risky. Many models are already in use or under development in all fields of video-assisted urologic surgery: ureteroscopy, percutaneous surgery, transurethral resection of the prostate, and laparoscopy. Although bench models are essential, simulation increasingly benefits from the achievements and development of computer technology. Still in its infancy, virtual reality simulation will certainly belong to tomorrow's teaching tools.

Difficult airway simulator intubation success rates using Commission on Accreditation of Medical Transport systems training standards.

PubMed

Thomas, Frank; Rhoades, Carol; Carpenter, Judi; Holleran, Renee; Handrahan, Diana

2011-01-01

This study was undertaken to evaluate difficult airway simulator intubation success rates using Commission on Accreditation of Medical Transport Systems (CAMTS) initial and maintenance intubation training standards on transport-RN novice intubators over a 1-year period. Twelve transport nurses were blinded to and randomly assigned five or six of 64 different difficult airway simulator scenarios. Intubation success rates were measured 1 month before training, 1 month after training, and 1 year later, following CAMTS initial and maintenance intubation standards. Outcome measurements included first attempt intubation rate, overall intubation success rate, number of attempts to intubation, time per attempt, time to intubation, and time between attempts. During the study, participants received no additional training or opportunities to intubate. First-attempt intubation rates significantly improved (P 5 .022) from 19% 1 month before training to 36% 1 month after training, but did not significantly change (P > .999) 1 year later following CAMTS maintenance standards (34%). Mean cumulative success rates did not significantly improve after four attempts or after 3.5 minutes. The overall mean time per attempt and time between attempts declined with subsequent intubation attempts. Using initial and maintenance CAMTS standards, simulator difficult airway intubation success rates are low in novice intubators. Our results suggest that one intubation/quarter may be enough to maintain difficult airway intubation success rates. Training significantly improves intubation rates. Little advantage occurs in intubation rates after four attempts or 3.5 minutes. Copyright © 2011 Air Medical Journal Associates. Published by Elsevier Inc. All rights reserved.

75 FR 35689 - System Personnel Training Reliability Standards

Federal Register 2010, 2011, 2012, 2013, 2014

2010-06-23

... using realistic simulations.\\14\\ \\13\\ Id. P 1331. \\14\\ Reliability Standard PER-002-0. 9. In Order No... development process to: (1) Include formal training requirements for reliability coordinators similar to those... simulation technology such as a simulator, virtual technology, or other technology in their emergency...

Development and Formative Evaluation of the "Educational Media In-Service Teacher Training Curriculum Standards"

ERIC Educational Resources Information Center

Yoshida, Hiroki

2010-01-01

The first Japanese "curriculum standards" for educational media/ICT in-service teacher training was announced by the Ministry of Education, Science and Culture in April 1973. Since then, the "curriculum standards" has been revised twice. The last revision was made in March 2006, based on the results of a preliminary study that…

Monitoring of Qualifications and Employment in Austria: An Empirical Approach Based on the Labour Force Survey

ERIC Educational Resources Information Center

Lassnigg, Lorenz; Vogtenhuber, Stefan

2011-01-01

The empirical approach referred to in this article describes the relationship between education and training (ET) supply and employment in Austria; the use of the new ISCED (International Standard Classification of Education) fields of study variable makes this approach applicable abroad. The purpose is to explore a system that produces timely…

Sample Selection for Training Cascade Detectors.

PubMed

Vállez, Noelia; Deniz, Oscar; Bueno, Gloria

2015-01-01

Automatic detection systems usually require large and representative training datasets in order to obtain good detection and false positive rates. Training datasets are such that the positive set has few samples and/or the negative set should represent anything except the object of interest. In this respect, the negative set typically contains orders of magnitude more images than the positive set. However, imbalanced training databases lead to biased classifiers. In this paper, we focus our attention on a negative sample selection method to properly balance the training data for cascade detectors. The method is based on the selection of the most informative false positive samples generated in one stage to feed the next stage. The results show that the proposed cascade detector with sample selection obtains on average better partial AUC and smaller standard deviation than the other compared cascade detectors.

Education and training initiatives for crisis management in the European Union: a web-based analysis of available programs.

PubMed

Ingrassia, Pier Luigi; Foletti, Marco; Djalali, Ahmadreza; Scarone, Piercarlo; Ragazzoni, Luca; Corte, Francesco Della; Kaptan, Kubilay; Lupescu, Olivera; Arculeo, Chris; von Arnim, Gotz; Friedl, Tom; Ashkenazi, Michael; Heselmann, Deike; Hreckovski, Boris; Khorram-Manesh, Amir; Khorrram-Manesh, Amir; Komadina, Radko; Lechner, Kostanze; Patru, Cristina; Burkle, Frederick M; Fisher, Philipp

2014-04-01

Education and training are key elements of disaster management. Despite national and international educational programs in disaster management, there is no standardized curriculum available to guide the European Union (EU) member states. European- based Disaster Training Curriculum (DITAC), a multiple university-based project financially supported by the EU, is charged with developing a holistic and highly-structured curriculum and courses for responders and crisis managers at a strategic and tactical level. The purpose of this study is to qualitatively assess the prevailing preferences and characteristics of disaster management educational and training initiatives (ETIs) at a postgraduate level that currently exist in the EU countries. An Internet-based qualitative search was conducted in 2012 to identify and analyze the current training programs in disaster management. The course characteristics were evaluated for curriculum, teaching methods, modality of delivery, target groups, and funding. The literature search identified 140 ETIs, the majority (78%) located in United Kingdom, France, and Germany. Master level degrees were the primary certificates granted to graduates. Face-to-face education was the most common teaching method (84%). Approximately 80% of the training initiatives offered multi- and cross-disciplinary disaster management content. A competency-based approach to curriculum content was present in 61% of the programs. Emergency responders at the tactical level were the main target group. Almost all programs were self-funded. Although ETIs currently exist, they are not broadly available in all 27 EU countries. Also, the curricula do not cover all key elements of disaster management in a standardized and competency-based structure. This study has identified the need to develop a standardized competency-based educational and training program for all European countries that will ensure the practice and policies that meet both the standards of care and the broader expectations for professionalization of the disaster and crisis workforce.

Evaluating ambulatory care training in Firoozgar hospital based on Iranian national standards of undergraduate medical education

PubMed Central

Sabzghabaei, Foroogh; Salajeghe, Mahla; Soltani Arabshahi, Seyed Kamran

2017-01-01

Background: In this study, ambulatory care training in Firoozgar hospital was evaluated based on Iranian national standards of undergraduate medical education related to ambulatory education using Baldrige Excellence Model. Moreover, some suggestions were offered to promote education quality in the current condition of ambulatory education in Firoozgar hospital and national standards using the gap analysis method. Methods: This descriptive analytic study was a kind of evaluation research performed using the standard check lists published by the office of undergraduate medical education council. Data were collected through surveying documents, interviewing, and observing the processes based on the Baldrige Excellence Model. After confirming the validity and reliability of the check lists, we evaluated the establishment level of the national standards of undergraduate medical education in the clinics of this hospital in the 4 following domains: educational program, evaluation, training and research resources, and faculty members. Data were analyzed according to the national standards of undergraduate medical education related to ambulatory education and the Baldrige table for scoring. Finally, the quality level of the current condition was determined as very appropriate, appropriate, medium, weak, and very weak. Results: In domains of educational program 62%, in evaluation 48%, in training and research resources 46%, in faculty members 68%, and in overall ratio, 56% of the standards were appropriate. Conclusion: The most successful domains were educational program and faculty members, but evaluation and training and research resources domains had a medium performance. Some domains and indicators were determined as weak and their quality needed to be improved, so it is suggested to provide the necessary facilities and improvements by attending to the quality level of the national standards of ambulatory education PMID:29951400

Objective assessment in residency-based training for transoral robotic surgery.

PubMed

Curry, Martin; Malpani, Anand; Li, Ryan; Tantillo, Thomas; Jog, Amod; Blanco, Ray; Ha, Patrick K; Califano, Joseph; Kumar, Rajesh; Richmon, Jeremy

2012-10-01

To develop a robotic surgery training regimen integrating objective skill assessment for otolaryngology and head and neck surgery trainees consisting of training modules of increasing complexity leading up to procedure-specific training. In particular, we investigated applications of such a training approach for surgical extirpation of oropharyngeal tumors via a transoral approach using the da Vinci robotic system. Prospective blinded data collection and objective evaluation (Objective Structured Assessment of Technical Skills [OSATS]) of three distinct phases using the da Vinci robotic surgical system in an academic university medical engineering/computer science laboratory setting. Between September 2010 and July 2011, eight otolaryngology-head and neck surgery residents and four staff experts from an academic hospital participated in three distinct phases of robotic surgery training involving 1) robotic platform operational skills, 2) set up of the patient side system, and 3) a complete ex vivo surgical extirpation of an oropharyngeal tumor located in the base of tongue. Trainees performed multiple (four) approximately equally spaced training sessions in each stage of the training. In addition to trainees, baseline performance data were obtained for the experts. Each surgical stage was documented with motion and event data captured from the application programming interfaces of the da Vinci system, as well as separate video cameras as appropriate. All data were assessed using automated skill measures of task efficiency and correlated with structured assessment (OSATS and similar Likert scale) from three experts to assess expert and trainee differences and compute automated and expert assessed learning curves. Our data show that such training results in an improved didactic robotic knowledge base and improved clinical efficiency with respect to the set up and console manipulation. Experts (e.g., average OSATS, 25; standard deviation [SD], 3.1; module 1, suturing) and trainees (average OSATS, 15.9; SD, 3.9; week 1) are well separated at the beginning of the training, and the separation reduces significantly (expert average OSATS, 27.6; SD, 2.7; trainee average OSATS, 24.2; SD, 6.8; module 3) at the conclusion of the training. Learning curves in each of the three stages show diminishing differences between the experts and trainees, which is also consistent with expert assessment. Subjective assessment by experts verified the clinical utility of the module 3 surgical environment, and a survey of trainees consistently rated the curriculum as very useful in progression to human operating room assistance. Structured curricular robotic surgery training with objective assessment promises to reduce the overhead for mentors, allow detailed assessment of human-machine interface skills, and create customized training models for individualized training. This preliminary study verifies the utility of such training in improving human-machine operations skills (module 1), and operating room and surgical skills (modules 2 and 3). In contrast to current coarse measures of total operating time and subjective assessment of error for short mass training sessions, these methods may allow individual tasks to be removed from the trainee regimen when skill levels are within the standard deviation of the experts for these tasks, which can greatly enhance overall efficiency of the training regimen and allow time for additional and more complex training to be incorporated in the same time frame. Copyright © 2012 The American Laryngological, Rhinological, and Otological Society, Inc.

Information Technologies in the System of Military Engineer Training of Cadets

ERIC Educational Resources Information Center

Khizhnaya, Anna V.; Kutepov, Maksim M.; Gladkova, Marina N.; Gladkov, Alexey V.; Dvornikova, Elena I.

2016-01-01

The necessity of enhancement of the information component in the military engineer training is determined by the result of a comparative analysis of global and national engineering education standards. The purpose is to substantiate the effectiveness and relevance of applying information technology in the system of military engineer training of…

A SYSTEMS APPROACH UTILIZING GENERAL-PURPOSE AND SPECIAL-PURPOSE TEACHING MACHINES.

ERIC Educational Resources Information Center

SILVERN, LEONARD C.

IN ORDER TO IMPROVE THE EMPLOYEE TRAINING-EVALUATION METHOD, TEACHING MACHINES AND PERFORMANCE AIDS MUST BE PHYSICALLY AND OPERATIONALLY INTEGRATED INTO THE SYSTEM, THUS RETURNING TRAINING TO THE ACTUAL JOB ENVIRONMENT. GIVEN THESE CONDITIONS, TRAINING CAN BE MEASURED, CALIBRATED, AND CONTROLLED WITH RESPECT TO ACTUAL JOB PERFORMANCE STANDARDS AND…

Public domain optical character recognition

NASA Astrophysics Data System (ADS)

Garris, Michael D.; Blue, James L.; Candela, Gerald T.; Dimmick, Darrin L.; Geist, Jon C.; Grother, Patrick J.; Janet, Stanley A.; Wilson, Charles L.

1995-03-01

A public domain document processing system has been developed by the National Institute of Standards and Technology (NIST). The system is a standard reference form-based handprint recognition system for evaluating optical character recognition (OCR), and it is intended to provide a baseline of performance on an open application. The system's source code, training data, performance assessment tools, and type of forms processed are all publicly available. The system recognizes the handprint entered on handwriting sample forms like the ones distributed with NIST Special Database 1. From these forms, the system reads hand-printed numeric fields, upper and lowercase alphabetic fields, and unconstrained text paragraphs comprised of words from a limited-size dictionary. The modular design of the system makes it useful for component evaluation and comparison, training and testing set validation, and multiple system voting schemes. The system contains a number of significant contributions to OCR technology, including an optimized probabilistic neural network (PNN) classifier that operates a factor of 20 times faster than traditional software implementations of the algorithm. The source code for the recognition system is written in C and is organized into 11 libraries. In all, there are approximately 19,000 lines of code supporting more than 550 subroutines. Source code is provided for form registration, form removal, field isolation, field segmentation, character normalization, feature extraction, character classification, and dictionary-based postprocessing. The recognition system has been successfully compiled and tested on a host of UNIX workstations. This paper gives an overview of the recognition system's software architecture, including descriptions of the various system components along with timing and accuracy statistics.

Development of a health care systems curriculum.

PubMed

Pruitt, Zachary; Mhaskar, Rahul; Kane, Bryan G; Barraco, Robert D; DeWaay, Deborah J; Rosenau, Alex M; Bresnan, Kristin A; Greenberg, Marna Rayl

2017-01-01

There is currently no gold standard for delivery of systems-based practice in medical education, and it is challenging to incorporate into medical education. Health systems competence requires physicians to understand patient care within the broader health care system and is vital to improving the quality of care clinicians provide. We describe a health systems curriculum that utilizes problem-based learning across 4 years of systems-based practice medical education at a single institution. This case study describes the application of a problem-based learning approach to system-based practice medical education. A series of behavioral statements, called entrustable professional activities, was created to assess student health system competence. Student evaluation of course curriculum design, delivery, and assessment was provided through web-based surveys. To meet competency standards for system-based practice, a health systems curriculum was developed and delivered across 4 years of medical school training. Each of the health system lectures and problem-based learning activities are described herein. The majority of first and second year medical students stated they gained working knowledge of health systems by engaging in these sessions. The majority of the 2016 graduating students (88.24%) felt that the course content, overall, prepared them for their career. A health systems curriculum in undergraduate medical education using a problem-based learning approach is feasible. The majority of students learning health systems curriculum through this format reported being prepared to improve individual patient care and optimize the health system's value (better care and health for lower cost).

Effect of information literacy training course on information literacy skills of undergraduate students of Isfahan University of Medical Sciences based on ACRL standards.

PubMed

Karimi, Zohreh; Ashrafi-Rizi, Hasan; Papi, Ahmad; Shahrzadi, Leila; Hassanzadeh, Akbar

2015-01-01

Information literacy is the basis for lifelong learning. Information literacy skills, especially for student in an environment that is full of information from multiple technologies are being developed is equally important. Information literacy is a set of cognitive and practical skills and like any other science, proper training is needed, and standard-based education is definitely better and evaluation would be easier. This study aimed to determine the impact of information literacy training course on information literacy skills of Isfahan University of Medical Sciences students based on ACRL standard in 2012. The study method is semi-experience with two group design (with pre-test and post-test) and applied. The data collection toll was a questionnaire assessing student's information literacy that developed by Davarpanah and Siamak and validity was confirmed by professional librarians and reliability as measured by Cronbach's alpha, was 0.83. The sample consisted of 50 undergraduate students from Isfahan University of Medical Sciences that by random sampling method was perch in both case and control groups. Before and after the training (once a week), a questionnaire was distributed between the two groups. This training was held in a classroom equipped with computers with internet access and in addition to training using brochures and librarian presentation, interactive methods such as discussion and exercises were used. The data were analyzed using SPSS version 20 software and two level of descriptive (mean and SD) and inferential statistics (t-test and t-paired). The results showed that the students' information literacy scores before the training was lower than average, so that in the control group was 32.96 and in the case group was 33.24; while information literacy scores in the case group significantly increased after the training (46.68). Also, the effect of education, respectively had a greater impact on the ability to access information (the second standard), ethics and legal use of information (the third standard), effective use of information (the fourth standard), critically evaluate information and its sources (the fifth standard). This study showed that the training was effective on enhancing students' information literacy skills as the greatest impact was on increasing the ability to access information. Due to low mean score information literacy in the context of object recognition, there is a need for more training in this area.

76 FR 57796 - Petition for Waiver of Compliance

Federal Register 2010, 2011, 2012, 2013, 2014

2011-09-16

... CFR part 232, Brake System Safety Standards for Freight and Other Non-Passenger Trains and Equipment; End-of-Train Devices and 49 CFR part 215, Railroad Freight Car Safety Standards. Presently, BRG's... railroad safety regulations contained at 49 CFR parts 232 and 215. FRA assigned the petition Docket Number...

75 FR 52059 - Petition for Waiver of Compliance

Federal Register 2010, 2011, 2012, 2013, 2014

2010-08-24

... compliance with certain requirements of 49 CFR part 232 --Brake System Safety Standards for Freight and Other Non-Passenger Trains and Equipment; End-of Train Devices and CFR Part 215--Railroad Freight Car Safety... requirements of its safety standards. The individual petition is described below, including the party seeking...

Virtual reality and the traditional method for phlebotomy training among college of nursing students in Kuwait: implications for nursing education and practice.

PubMed

Vidal, Victoria L; Ohaeri, Beatrice M; John, Pamela; Helen, Delles

2013-01-01

This quasi-experimental study, with a control group and experimental group, compares the effectiveness of virtual reality simulators on developing phlebotomy skills of nursing students with the effectiveness of traditional methods of teaching. Performance of actual phlebotomy on a live client was assessed after training, using a standardized form. Findings showed that students who were exposed to the virtual reality simulator performed better in the following performance metrics: pain factor, hematoma formation, and number of reinsertions. This study confirms that the use of the virtual reality-based system to supplement the traditional method may be the optimal program for training.

Comparing self-guided learning and educator-guided learning formats for simulation-based clinical training.

PubMed

Brydges, Ryan; Carnahan, Heather; Rose, Don; Dubrowski, Adam

2010-08-01

In this paper, we tested the over-arching hypothesis that progressive self-guided learning offers equivalent learning benefit vs. proficiency-based training while limiting the need to set proficiency standards. We have shown that self-guided learning is enhanced when students learn on simulators that progressively increase in fidelity during practice. Proficiency-based training, a current gold-standard training approach, requires achievement of a criterion score before students advance to the next learning level. Baccalaureate nursing students (n = 15/group) practised intravenous catheterization using simulators that differed in fidelity (i.e. students' perceived realism). Data were collected in 2008. Proficiency-based students advanced from low- to mid- to high-fidelity after achieving a proficiency criterion at each level. Progressive students self-guided their progression from low- to mid- to high-fidelity. Yoked control students followed an experimenter-defined progressive practice schedule. Open-ended students moved freely between the simulators. One week after practice, blinded experts evaluated students' skill transfer on a standardized patient simulation. Group differences were examined using analyses of variance. Proficiency-based students scored highest on the high-fidelity post-test (effect size = 1.22). An interaction effect showed that the Progressive and Open-ended groups maintained their performance from post-test to transfer test, whereas the Proficiency-based and Yoked control groups experienced a significant decrease (P < 0.05). Surprisingly, most Open-ended students (73%) chose the progressive practice schedule. Progressive training and proficiency-based training resulted in equivalent transfer test performance, suggesting that progressive students effectively self-guided when to transition between simulators. Students' preference for the progressive practice schedule indicates that educators should consider this sequence for simulation-based training.

The Quality Adaptation Model: Adaptation and Adoption of the Quality Standard ISO/IEC 19796-1 for Learning, Education, and Training

ERIC Educational Resources Information Center

Pawlowski, Jan M.

2007-01-01

In 2005, the new quality standard for learning, education, and training, ISO/IEC 19796-1, was published. Its purpose is to help educational organizations to develop quality systems and to improve the quality of their processes, products, and services. In this article, the standard is presented and compared to existing approaches, showing the…

Using athletic training clinical education standards in radiography.

PubMed

Giordano, Shelley; Harris, Katherine

2012-01-01

The selection of clinical education sites for radiography students is based on availability, access to radiographic examinations, and appropriate student-to-technologist ratio. Radiography program directors are not required to evaluate sites based on their educational validity (eg, the clinical instructor's knowledge of basic teaching and learning principles, how well the site communicates with the program, or the clinical instructor's involvement in professional organizations). The purpose of this study was to determine if a set of 12 clinical education standards used in athletic training would be applicable and beneficial to radiography program directors when selecting clinical sites for students. A survey concerning the applicability of the athletic training standards to radiography site selection was completed by 270 directors of radiography programs accredited by the Joint Review Committee on Education in Radiologic Technology. The survey results indicated the athletic training clinical education standards were considered applicable to the selection of clinical sites for radiography students and would be beneficial to radiography program directors when selecting sites.

Effects of Computer-Based Training on Procedural Modifications to Standard Functional Analyses

ERIC Educational Resources Information Center

Schnell, Lauren K.; Sidener, Tina M.; DeBar, Ruth M.; Vladescu, Jason C.; Kahng, SungWoo

2018-01-01

Few studies have evaluated methods for training decision-making when functional analysis data are undifferentiated. The current study evaluated computer-based training to teach 20 graduate students to arrange functional analysis conditions, analyze functional analysis data, and implement procedural modifications. Participants were exposed to…

Mass detection in digital breast tomosynthesis: Deep convolutional neural network with transfer learning from mammography.

PubMed

Samala, Ravi K; Chan, Heang-Ping; Hadjiiski, Lubomir; Helvie, Mark A; Wei, Jun; Cha, Kenny

2016-12-01

Develop a computer-aided detection (CAD) system for masses in digital breast tomosynthesis (DBT) volume using a deep convolutional neural network (DCNN) with transfer learning from mammograms. A data set containing 2282 digitized film and digital mammograms and 324 DBT volumes were collected with IRB approval. The mass of interest on the images was marked by an experienced breast radiologist as reference standard. The data set was partitioned into a training set (2282 mammograms with 2461 masses and 230 DBT views with 228 masses) and an independent test set (94 DBT views with 89 masses). For DCNN training, the region of interest (ROI) containing the mass (true positive) was extracted from each image. False positive (FP) ROIs were identified at prescreening by their previously developed CAD systems. After data augmentation, a total of 45 072 mammographic ROIs and 37 450 DBT ROIs were obtained. Data normalization and reduction of non-uniformity in the ROIs across heterogeneous data was achieved using a background correction method applied to each ROI. A DCNN with four convolutional layers and three fully connected (FC) layers was first trained on the mammography data. Jittering and dropout techniques were used to reduce overfitting. After training with the mammographic ROIs, all weights in the first three convolutional layers were frozen, and only the last convolution layer and the FC layers were randomly initialized again and trained using the DBT training ROIs. The authors compared the performances of two CAD systems for mass detection in DBT: one used the DCNN-based approach and the other used their previously developed feature-based approach for FP reduction. The prescreening stage was identical in both systems, passing the same set of mass candidates to the FP reduction stage. For the feature-based CAD system, 3D clustering and active contour method was used for segmentation; morphological, gray level, and texture features were extracted and merged with a linear discriminant classifier to score the detected masses. For the DCNN-based CAD system, ROIs from five consecutive slices centered at each candidate were passed through the trained DCNN and a mass likelihood score was generated. The performances of the CAD systems were evaluated using free-response ROC curves and the performance difference was analyzed using a non-parametric method. Before transfer learning, the DCNN trained only on mammograms with an AUC of 0.99 classified DBT masses with an AUC of 0.81 in the DBT training set. After transfer learning with DBT, the AUC improved to 0.90. For breast-based CAD detection in the test set, the sensitivity for the feature-based and the DCNN-based CAD systems was 83% and 91%, respectively, at 1 FP/DBT volume. The difference between the performances for the two systems was statistically significant (p-value < 0.05). The image patterns learned from the mammograms were transferred to the mass detection on DBT slices through the DCNN. This study demonstrated that large data sets collected from mammography are useful for developing new CAD systems for DBT, alleviating the problem and effort of collecting entirely new large data sets for the new modality.

A Standards-Based Inventory for Assessing Perceived Importance of and Confidence in Using ASGW's Core Group Work Skills

ERIC Educational Resources Information Center

Wilson, F. Robert; Newmeyer, Mark D.

2008-01-01

Since the early 1980s, ASGW (Association for Specialists in Group Work) has promulgated standards for training group workers. Now, in their third revision, these standards establish core group work knowledge and skills to be included in all counselor training programs. To advance research on the relationship between mastery of ASGW's core…

[Medical doctor in mountain rescue service - a profession's perspective].

PubMed

Putzke, Matthias

2008-01-01

Helicopter emergency services (HEMS) carrying doctors trained in emergency medicine represent a well established system for primary care with increasing professionalism since their implementation in the seventies until now. However, considerable differences persist in Europe concerning the structure as well as integration of the system in the entire organisation of area-wide demands. Based on the particular geographic conditions in the alps which are highly associated with challenges for man and material a dense network of helicopter airbases has been established. Hence, this system accounts for the social, economical and touristic requirements of this region in terms of providing sufficient emergency medical treatment. In addition to statutory and professional provisions qualification requirements for emergency doctors comprehend extensive alpine training. Primarily this provides personal safety as well as security for the entire team and the patient which particularly applies for technical rope rescue. Advanced all-season training is compulsory due to seasonal differences in casualties. Well harmonized training with cross-border validity is not available to-date. Hence, the development of obligatory standard operating procedures should be the major goal of medical associations and societies.

75 FR 22844 - Construction Fall Protection Systems Criteria and Practices and Training Requirements; Extension...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-04-30

...] Construction Fall Protection Systems Criteria and Practices and Training Requirements; Extension of the Office of Management and Budget's (OMB) Approval of Information Collection (Paperwork) Requirements AGENCY... requirements contained in the construction standards on Fall Protection Systems Criteria and Practices (29 CFR...

Cost considerations in using simulations for medical training.

PubMed

Fletcher, J D; Wind, Alexander P

2013-10-01

This article reviews simulation used for medical training, techniques for assessing simulation-based training, and cost analyses that can be included in such assessments. Simulation in medical training appears to take four general forms: human actors who are taught to simulate illnesses and ailments in standardized ways; virtual patients who are generally presented via computer-controlled, multimedia displays; full-body manikins that simulate patients using electronic sensors, responders, and controls; and part-task anatomical simulations of various body parts and systems. Techniques for assessing costs include benefit-cost analysis, return on investment, and cost-effectiveness analysis. Techniques for assessing the effectiveness of simulation-based medical training include the use of transfer effectiveness ratios and incremental transfer effectiveness ratios to measure transfer of knowledge and skill provided by simulation to the performance of medical procedures. Assessment of costs and simulation effectiveness can be combined with measures of transfer using techniques such as isoperformance analysis to identify ways of minimizing costs without reducing performance effectiveness or maximizing performance without increasing costs. In sum, economic analysis must be considered in training assessments if training budgets are to compete successfully with other requirements for funding. Reprint & Copyright © 2013 Association of Military Surgeons of the U.S.

A study of machine-learning-based approaches to extract clinical entities and their assertions from discharge summaries.

PubMed

Jiang, Min; Chen, Yukun; Liu, Mei; Rosenbloom, S Trent; Mani, Subramani; Denny, Joshua C; Xu, Hua

2011-01-01

The authors' goal was to develop and evaluate machine-learning-based approaches to extracting clinical entities-including medical problems, tests, and treatments, as well as their asserted status-from hospital discharge summaries written using natural language. This project was part of the 2010 Center of Informatics for Integrating Biology and the Bedside/Veterans Affairs (VA) natural-language-processing challenge. The authors implemented a machine-learning-based named entity recognition system for clinical text and systematically evaluated the contributions of different types of features and ML algorithms, using a training corpus of 349 annotated notes. Based on the results from training data, the authors developed a novel hybrid clinical entity extraction system, which integrated heuristic rule-based modules with the ML-base named entity recognition module. The authors applied the hybrid system to the concept extraction and assertion classification tasks in the challenge and evaluated its performance using a test data set with 477 annotated notes. Standard measures including precision, recall, and F-measure were calculated using the evaluation script provided by the Center of Informatics for Integrating Biology and the Bedside/VA challenge organizers. The overall performance for all three types of clinical entities and all six types of assertions across 477 annotated notes were considered as the primary metric in the challenge. Systematic evaluation on the training set showed that Conditional Random Fields outperformed Support Vector Machines, and semantic information from existing natural-language-processing systems largely improved performance, although contributions from different types of features varied. The authors' hybrid entity extraction system achieved a maximum overall F-score of 0.8391 for concept extraction (ranked second) and 0.9313 for assertion classification (ranked fourth, but not statistically different than the first three systems) on the test data set in the challenge.

Proposed Scientific Support to the Land Vehicle Crew Training System (LVCTS) Project Requirements Definition

DTIC Science & Technology

2013-01-01

proposed acquisition of a variety of armoured vehicle simulators for training within the Canadian Forces. The Directorate of Land Requirements (DLR... armoured vehicle operations under the Land Vehicle Crew Training System (LVCTS) project. DLR has published a Letter of Interest (LOI) to solicit input...LVCTS project staff to discuss the intent of the project. Qualification Standards and Training Plans for several military armoured vehicle

49 CFR 232.213 - Extended haul trains.

Code of Federal Regulations, 2010 CFR

2010-10-01

..., DEPARTMENT OF TRANSPORTATION BRAKE SYSTEM SAFETY STANDARDS FOR FREIGHT AND OTHER NON-PASSENGER TRAINS AND... extended haul trains will originate and a description of the trains that will be operated as extended haul.... (5) The train shall have no more than one pick-up and one set-out en route, except for the set-out of...

Standard object recognition memory and "what" and "where" components: Improvement by post-training epinephrine in highly habituated rats.

PubMed

Jurado-Berbel, Patricia; Costa-Miserachs, David; Torras-Garcia, Meritxell; Coll-Andreu, Margalida; Portell-Cortés, Isabel

2010-02-11

The present work examined whether post-training systemic epinephrine (EPI) is able to modulate short-term (3h) and long-term (24 h and 48 h) memory of standard object recognition, as well as long-term (24 h) memory of separate "what" (object identity) and "where" (object location) components of object recognition. Although object recognition training is associated to low arousal levels, all the animals received habituation to the training box in order to further reduce emotional arousal. Post-training EPI improved long-term (24 h and 48 h), but not short-term (3 h), memory in the standard object recognition task, as well as 24 h memory for both object identity and object location. These data indicate that post-training epinephrine: (1) facilitates long-term memory for standard object recognition; (2) exerts separate facilitatory effects on "what" (object identity) and "where" (object location) components of object recognition; and (3) is capable of improving memory for a low arousing task even in highly habituated rats.

Control of Complex Dynamic Systems by Neural Networks

NASA Technical Reports Server (NTRS)

Spall, James C.; Cristion, John A.

1993-01-01

This paper considers the use of neural networks (NN's) in controlling a nonlinear, stochastic system with unknown process equations. The NN is used to model the resulting unknown control law. The approach here is based on using the output error of the system to train the NN controller without the need to construct a separate model (NN or other type) for the unknown process dynamics. To implement such a direct adaptive control approach, it is required that connection weights in the NN be estimated while the system is being controlled. As a result of the feedback of the unknown process dynamics, however, it is not possible to determine the gradient of the loss function for use in standard (back-propagation-type) weight estimation algorithms. Therefore, this paper considers the use of a new stochastic approximation algorithm for this weight estimation, which is based on a 'simultaneous perturbation' gradient approximation that only requires the system output error. It is shown that this algorithm can greatly enhance the efficiency over more standard stochastic approximation algorithms based on finite-difference gradient approximations.

Analyzing AQP Data to Improve Electronic Flight Bag (EFB) Operations and Training

NASA Technical Reports Server (NTRS)

Seamster, Thomas L.; Kanki, Barbara

2010-01-01

Key points include: Initiate data collection and analysis early in the implementation process. Use data to identify procedural and training refinements. Use a de-identified system to analyze longitudinal data. Use longitudinal I/E data to improve their standardization. Identify above average pilots and crews and use their performance to specify best practices. Analyze below average crew performance data to isolate problems with the training, evaluator standardization and pilot proficiency.

Analysis of curricular reform practices at Chinese medical schools.

PubMed

Huang, Lei; Cai, Qiaoling; Cheng, Liming; Kosik, Russell; Mandell, Greg; Wang, Shuu-Jiun; Xu, Guo-Tong; Fan, Angela P

2014-01-01

A comprehensive search of the literature published between 2001 and 2010 was performed to gain a greater understanding of curricular reform practices at Chinese medical schools. There were 10,948 studies published between 2001 and 2010 that were retrieved from the database. Following preliminary screening, 76 publications from 49 different medical schools were selected. Thirty-one publications regarding clinical medicine curricular reforms were analyzed further. Of the 76 studies, 53 described curricular reforms that were instituted in theoretical courses, 22 described curricular reforms that were instituted in experimental courses, and 1 described curricular reforms that were instituted in a clinical skills training course. Of the 31 clinical medicine publications, 2 described reforms that were implemented for 3-year program medical students, 12 described reforms that were implemented for 5-year program medical students, 6 described reforms that were implemented for 7-year program medical students, and 2 described reforms that were implemented for 8-year program medical students. Currently, the majority of medical schools in China use the discipline-based curriculum model. Thirteen studies described transition to an organ-system-based curriculum model, 1 study described transition to a problem-based curriculum model, and 3 studies described transition to a clinical presentation-based curriculum model. In 7 studies educators decided to retain the discipline-based curriculum model while integrating 1 or several new courses to remedy the weaker aspects of the traditional curriculum, in 7 studies educators decided to integrate the preclinical courses with the clinical courses by using the systemic-integrating curricular system that dilutes classical disciplines and integrates material based on organ systems, and in 2 studies educators limited reforms to clinical courses only. Eight studies discussed the implementation of a formative evaluation system, 4 studies discussed faculty training, and 15 studies discussed the application of various instructional methods. Other issues that were also addressed include enhancing research, improving patient-doctor communication, developing interpersonal and teamwork skills, cultivating independent lifelong learning habits, and improving problem-solving capabilities. The medical schools in our study have adopted various comprehensive curricular changes, moving from a knowledge-based to a competency-based model, and from traditional standards to international standards. Many institutions face challenges when implementing curricular reforms, such as what to integrate and how to do so, the unintended omission of important material, ensuring coordination between different organizations and departments, and the training of faculty.

Pilot training: What can surgeons learn from it?

PubMed

Sommer, Kai-Jörg

2014-03-01

To provide healthcare professionals with an insight into training in aviation and its possible transfer into surgery. From research online and into company archives, relevant publications and information were identified. Current airline pilot training consists of two categories, basic training and type-rating. Training methods comprise classroom instruction, computer-based training and practical training, in either the aircraft or a flight-training device, which ranges from a fixed-base flight-training device to a full flight simulator. Pilot training not only includes technical and procedural instruction, but also training in non-technical skills like crisis management, decision-making, leadership and communication. Training syllabuses, training devices and instructors are internationally standardized and these standards are legally binding. Re-qualification and recurrent training are mandatory at all stages of a pilot's and instructor's career. Surgeons and pilots have much in common, i.e., they work in a 'real-time' three-dimensional environment under high physiological and psychological stress, operating expensive equipment, and the ultimate cost for error is measured in human lives. However, their training differs considerably. Transferring these well-tried aviation methods into healthcare will make surgical training more efficient, more effective and ultimately safer.

Haptic display for the VR arthroscopy training simulator

NASA Astrophysics Data System (ADS)

Ziegler, Rolf; Brandt, Christoph; Kunstmann, Christian; Mueller, Wolfgang; Werkhaeuser, Holger

1997-05-01

A specific desire to find new training methods arose from the new fields called 'minimal invasive surgery.' With the technical advance modern video arthroscopy became the standard procedure in the ORs. Holding the optical system with the video camera in one hand, watching the operation field on the monitor, the other hand was free to guide, e.g., a probe. As arthroscopy became a more common procedure it became obvious that some sort of special training was necessary to guarantee a certain level of qualification of the surgeons. Therefore, a hospital in Frankfurt, Germany approached the Fraunhofer Institute for Computer Graphics to develop a training system for arthroscopy based on VR techniques. At least the main drawback of the developed simulator is the missing of haptic perception, especially of force feedback. In cooperation with the Department of Electro-Mechanical Construction at the Darmstadt Technical University we have designed and built a haptic display for the VR arthroscopy training simulator. In parallel we developed a concept for the integration of the haptic display in a configurable way.

Artificial neural network-aided image analysis system for cell counting.

PubMed

Sjöström, P J; Frydel, B R; Wahlberg, L U

1999-05-01

In histological preparations containing debris and synthetic materials, it is difficult to automate cell counting using standard image analysis tools, i.e., systems that rely on boundary contours, histogram thresholding, etc. In an attempt to mimic manual cell recognition, an automated cell counter was constructed using a combination of artificial intelligence and standard image analysis methods. Artificial neural network (ANN) methods were applied on digitized microscopy fields without pre-ANN feature extraction. A three-layer feed-forward network with extensive weight sharing in the first hidden layer was employed and trained on 1,830 examples using the error back-propagation algorithm on a Power Macintosh 7300/180 desktop computer. The optimal number of hidden neurons was determined and the trained system was validated by comparison with blinded human counts. System performance at 50x and lO0x magnification was evaluated. The correlation index at 100x magnification neared person-to-person variability, while 50x magnification was not useful. The system was approximately six times faster than an experienced human. ANN-based automated cell counting in noisy histological preparations is feasible. Consistent histology and computer power are crucial for system performance. The system provides several benefits, such as speed of analysis and consistency, and frees up personnel for other tasks.

Education in Disaster Management and Emergencies: Defining a New European Course.

PubMed

Khorram-Manesh, Amir; Ashkenazi, Michael; Djalali, Ahmadreza; Ingrassia, Pier Luigi; Friedl, Tom; von Armin, Gotz; Lupesco, Olivera; Kaptan, Kubilay; Arculeo, Chris; Hreckovski, Boris; Komadina, Radko; Fisher, Philipp; Voigt, Stefan; James, James; Gursky, Elin

2015-06-01

Unremitting natural disasters, deliberate threats, pandemics, and humanitarian suffering resulting from conflict situations necessitate swift and effective response paradigms. The European Union's (EU) increasing visibility as a disaster response enterprise suggests the need not only for financial contribution but also for instituting a coherent disaster response approach and management structure. The DITAC (Disaster Training Curriculum) project identified deficiencies in current responder training approaches and analyzed the characteristics and content required for a new, standardized European course in disaster management and emergencies. Over 35 experts from within and outside the EU representing various organizations and specialties involved in disaster management composed the DITAC Consortium. These experts were also organized into 5 specifically tasked working groups. Extensive literature reviews were conducted to identify requirements and deficiencies and to craft a new training concept based on research trends and lessons learned. A pilot course and program dissemination plan was also developed. The lack of standardization was repeatedly highlighted as a serious deficiency in current disaster training methods, along with gaps in the command, control, and communication levels. A blended and competency-based teaching approach using exercises combined with lectures was recommended to improve intercultural and interdisciplinary integration. The goal of a European disaster management course should be to standardize and enhance intercultural and inter-agency performance across the disaster management cycle. A set of minimal standards and evaluation metrics can be achieved through consensus, education, and training in different units. The core of the training initiative will be a unit that presents a realistic situation "scenario-based training."

Smartphone-based reminder system to promote pelvic floor muscle training for the management of postnatal urinary incontinence: historical control study with propensity score-matched analysis.

PubMed

Kinouchi, Kaori; Ohashi, Kazutomo

2018-01-01

The purpose of this study was to evaluate the efficacy of a smartphone-based reminder system in promoting pelvic floor muscle training (PFMT) to help postpartum women manage urinary incontinence (UI). Forty-nine and 212 postpartum women in the intervention and control groups, respectively, received PFMT guidance using a leaflet and verbal instruction as the standard care at an obstetrics clinic in Japan. Women in the intervention group also received PFMT support using the smartphone-based reminder system between January and August 2014. For analysis, they were compared with historical controls between February 2011 and January 2012, who did not receive such support and were chosen by propensity score matching. The outcomes examined were PFMT adherence and UI prevalence. The former consisted of implementation rate (i.e., the percentage of women who reported performing PFMT during the intervention period), training intensity (i.e., the number of pelvic floor muscle contractions (PFMCs) per day), and training frequency (i.e., the number of days PFMT was performed per week); the latter consisted of self-reported UI prevalence at baseline and at the end of the eight-week intervention period. Propensity score matching resulted in 58 postpartum women ( n  = 29 per group). The intervention group exhibited better PFMT adherence than the control group, in terms of PFMT implementation rate (69 vs. 31%, p  = 0.008), median training intensity (15 vs. 1 PFMC reps/day, p  = 0.006), and training frequency (7 vs. 3 days/week, p  < 0.001). UI prevalence was not different between the groups at baseline, but was significantly reduced in the intervention group at eight weeks (0 vs. 24%, p  = 0.004). Our smartphone-based reminder system appears promising in enhancing PFMT adherence and managing postpartum UI in postpartum women. By enhancing PFMT adherence and improving women's ability to manage the condition, the reminder system could improve the health-related quality of life of postpartum women with UI.

Obtaining greater value from health care: the roles of the U.S. government.

PubMed

Schoenbaum, Stephen C; Audet, Anne-Marie J; Davis, Karen

2003-01-01

The problems of quality and cost in the U.S. health care system are unlikely to be solved without strong leadership from the federal government, which can mobilize action to set national priorities for quality; develop and promulgate standards for care; and stimulate implementation of performance measures and standards for providers. All of these functions would best be carried out by a new federal agency. Furthermore, the federal government should design payment policies based on the performance standards, invest in needed information technology, and invest in research related to improving care and in training professionals to support nationwide quality improvement.

Why standard brain-computer interface (BCI) training protocols should be changed: an experimental study.

PubMed

Jeunet, Camille; Jahanpour, Emilie; Lotte, Fabien

2016-06-01

While promising, electroencephaloraphy based brain-computer interfaces (BCIs) are barely used due to their lack of reliability: 15% to 30% of users are unable to control a BCI. Standard training protocols may be partly responsible as they do not satisfy recommendations from psychology. Our main objective was to determine in practice to what extent standard training protocols impact users' motor imagery based BCI (MI-BCI) control performance. We performed two experiments. The first consisted in evaluating the efficiency of a standard BCI training protocol for the acquisition of non-BCI related skills in a BCI-free context, which enabled us to rule out the possible impact of BCIs on the training outcome. Thus, participants (N = 54) were asked to perform simple motor tasks. The second experiment was aimed at measuring the correlations between motor tasks and MI-BCI performance. The ten best and ten worst performers of the first study were recruited for an MI-BCI experiment during which they had to learn to perform two MI tasks. We also assessed users' spatial ability and pre-training μ rhythm amplitude, as both have been related to MI-BCI performance in the literature. Around 17% of the participants were unable to learn to perform the motor tasks, which is close to the BCI illiteracy rate. This suggests that standard training protocols are suboptimal for skill teaching. No correlation was found between motor tasks and MI-BCI performance. However, spatial ability played an important role in MI-BCI performance. In addition, once the spatial ability covariable had been controlled for, using an ANCOVA, it appeared that participants who faced difficulty during the first experiment improved during the second while the others did not. These studies suggest that (1) standard MI-BCI training protocols are suboptimal for skill teaching, (2) spatial ability is confirmed as impacting on MI-BCI performance, and (3) when faced with difficult pre-training, subjects seemed to explore more strategies and therefore learn better.

Advanced training systems

NASA Technical Reports Server (NTRS)

Savely, Robert T.; Loftin, R. Bowen

1990-01-01

Training is a major endeavor in all modern societies. Common training methods include training manuals, formal classes, procedural computer programs, simulations, and on-the-job training. NASA's training approach has focussed primarily on on-the-job training in a simulation environment for both crew and ground based personnel. NASA must explore new approaches to training for the 1990's and beyond. Specific autonomous training systems are described which are based on artificial intelligence technology for use by NASA astronauts, flight controllers, and ground based support personnel that show an alternative to current training systems. In addition to these specific systems, the evolution of a general architecture for autonomous intelligent training systems that integrates many of the features of traditional training programs with artificial intelligence techniques is presented. These Intelligent Computer Aided Training (ICAT) systems would provide much of the same experience that could be gained from the best on-the-job training.

Fast attainment of computer cursor control with noninvasively acquired brain signals

NASA Astrophysics Data System (ADS)

Bradberry, Trent J.; Gentili, Rodolphe J.; Contreras-Vidal, José L.

2011-06-01

Brain-computer interface (BCI) systems are allowing humans and non-human primates to drive prosthetic devices such as computer cursors and artificial arms with just their thoughts. Invasive BCI systems acquire neural signals with intracranial or subdural electrodes, while noninvasive BCI systems typically acquire neural signals with scalp electroencephalography (EEG). Some drawbacks of invasive BCI systems are the inherent risks of surgery and gradual degradation of signal integrity. A limitation of noninvasive BCI systems for two-dimensional control of a cursor, in particular those based on sensorimotor rhythms, is the lengthy training time required by users to achieve satisfactory performance. Here we describe a novel approach to continuously decoding imagined movements from EEG signals in a BCI experiment with reduced training time. We demonstrate that, using our noninvasive BCI system and observational learning, subjects were able to accomplish two-dimensional control of a cursor with performance levels comparable to those of invasive BCI systems. Compared to other studies of noninvasive BCI systems, training time was substantially reduced, requiring only a single session of decoder calibration (~20 min) and subject practice (~20 min). In addition, we used standardized low-resolution brain electromagnetic tomography to reveal that the neural sources that encoded observed cursor movement may implicate a human mirror neuron system. These findings offer the potential to continuously control complex devices such as robotic arms with one's mind without lengthy training or surgery.

Simulation-Based Training for Colonoscopy

PubMed Central

Preisler, Louise; Svendsen, Morten Bo Søndergaard; Nerup, Nikolaj; Svendsen, Lars Bo; Konge, Lars

2015-01-01

Abstract The aim of this study was to create simulation-based tests with credible pass/fail standards for 2 different fidelities of colonoscopy models. Only competent practitioners should perform colonoscopy. Reliable and valid simulation-based tests could be used to establish basic competency in colonoscopy before practicing on patients. Twenty-five physicians (10 consultants with endoscopic experience and 15 fellows with very little endoscopic experience) were tested on 2 different simulator models: a virtual-reality simulator and a physical model. Tests were repeated twice on each simulator model. Metrics with discriminatory ability were identified for both modalities and reliability was determined. The contrasting-groups method was used to create pass/fail standards and the consequences of these were explored. The consultants significantly performed faster and scored higher than the fellows on both the models (P < 0.001). Reliability analysis showed Cronbach α = 0.80 and 0.87 for the virtual-reality and the physical model, respectively. The established pass/fail standards failed one of the consultants (virtual-reality simulator) and allowed one fellow to pass (physical model). The 2 tested simulations-based modalities provided reliable and valid assessments of competence in colonoscopy and credible pass/fail standards were established for both the tests. We propose to use these standards in simulation-based training programs before proceeding to supervised training on patients. PMID:25634177

A Standardized System of Training Intensity Guidelines for the Sports of Track and Field and Cross Country

ERIC Educational Resources Information Center

Belcher, Christopher P.; Pemberton, Cynthia Lee A.

2012-01-01

Accurate quantification of training intensity is an essential component of a training program (Rowbottom, 2000). A training program designed to optimize athlete performance abilities cannot be practically planned or implemented without a valid and reliable indication of training intensity and its effect on the physiological mechanisms of the human…

Evaluation of a stereoscopic camera-based three-dimensional viewing workstation for ophthalmic surgery.

PubMed

Bhadri, Prashant R; Rowley, Adrian P; Khurana, Rahul N; Deboer, Charles M; Kerns, Ralph M; Chong, Lawrence P; Humayun, Mark S

2007-05-01

To evaluate the effectiveness of a prototype stereoscopic camera-based viewing system (Digital Microsurgical Workstation, three-dimensional (3D) Vision Systems, Irvine, California, USA) for anterior and posterior segment ophthalmic surgery. Institutional-based prospective study. Anterior and posterior segment surgeons performed designated standardized tasks on porcine eyes after training on prosthetic plastic eyes. Both anterior and posterior segment surgeons were able to complete tasks requiring minimal or moderate stereoscopic viewing. The results indicate that the system provides improved ergonomics. Improvements in key viewing performance areas would further enhance the value over a conventional operating microscope. The performance of the prototype system is not at par with the planned commercial system. With continued development of this technology, the three- dimensional system may be a novel viewing system in ophthalmic surgery with improved ergonomics with respect to traditional microscopic viewing.

In-Flight Simulator for IFR Training

NASA Technical Reports Server (NTRS)

Parker, L. C.

1986-01-01

Computer-controlled unit feeds navigation signals to airplane instruments. Electronic training system allows students to learn to fly according to instrument flight rules (IFR) in uncrowded airspace. New system self-contained IFR simulator carried aboard training plane. Generates signals and commands for standard instruments on airplane, including navigational receiver, distance-measuring equipment, automatic direction finder, a marker-beacon receiver, altimeter, airspeed indicator, and heading indicator.

Power System Electrician: Apprenticeship Course Outline. Apprenticeship and Industry Training. 4609

ERIC Educational Resources Information Center

Alberta Advanced Education and Technology, 2009

2009-01-01

The graduate of the Power System Electrician apprenticeship training is a journeyman who will be able to: (1) responsibly do all work tasks expected of a journeyman; (2) supervise, train and coach apprentices; (3) use and maintain hand and power tools to the standards of competency and safety required in the trade; (4) read and interpret drawing,…

The National Resuscitation Council, Singapore, and 34 years of resuscitation training: 1983 to 2017.

PubMed

Anantharaman, Venkataraman

2017-07-01

Training in the modern form of cardiopulmonary resuscitation (CPR) started in Singapore in 1983. For the first 15 years, the expansion of training programmes was mainly owing to the interest of a few individuals. Public training in the skill was minimal. In an area of medical care where the greatest opportunity for benefit lies in employing core resuscitation skills in the prehospital environment, very little was being done to address such a need. In 1998, a group of physicians, working together with the Ministry of Health, set up the National Resuscitation Council (NRC). Over the years, the NRC has created national guidelines on resuscitation and reviewed them at five-yearly intervals. Provider training manuals are now available for most programmes. The NRC has set up an active accreditation system for monitoring and maintaining standards of life support training. This has led to a large increase in the number of training centres, as well as recognition and adoption of the council's guidelines in the country. The NRC has also actively promoted the use of bystander CPR through community-based programmes, resulting in a rise in the number of certified providers. Improving the chain of survival, through active community-based training programmes, will likely lead to more lives being saved from sudden cardiac arrest. Copyright: © Singapore Medical Association.

The National Resuscitation Council, Singapore, and 34 years of resuscitation training: 1983 to 2017

PubMed Central

Anantharaman, Venkataraman

2017-01-01

Training in the modern form of cardiopulmonary resuscitation (CPR) started in Singapore in 1983. For the first 15 years, the expansion of training programmes was mainly owing to the interest of a few individuals. Public training in the skill was minimal. In an area of medical care where the greatest opportunity for benefit lies in employing core resuscitation skills in the prehospital environment, very little was being done to address such a need. In 1998, a group of physicians, working together with the Ministry of Health, set up the National Resuscitation Council (NRC). Over the years, the NRC has created national guidelines on resuscitation and reviewed them at five-yearly intervals. Provider training manuals are now available for most programmes. The NRC has set up an active accreditation system for monitoring and maintaining standards of life support training. This has led to a large increase in the number of training centres, as well as recognition and adoption of the council’s guidelines in the country. The NRC has also actively promoted the use of bystander CPR through community-based programmes, resulting in a rise in the number of certified providers. Improving the chain of survival, through active community-based training programmes, will likely lead to more lives being saved from sudden cardiac arrest. PMID:28741008

A randomized, controlled trial of in situ pediatric advanced life support recertification ("pediatric advanced life support reconstructed") compared with standard pediatric advanced life support recertification for ICU frontline providers*.

PubMed

Kurosawa, Hiroshi; Ikeyama, Takanari; Achuff, Patricia; Perkel, Madeline; Watson, Christine; Monachino, Annemarie; Remy, Daphne; Deutsch, Ellen; Buchanan, Newton; Anderson, Jodee; Berg, Robert A; Nadkarni, Vinay M; Nishisaki, Akira

2014-03-01

Recent evidence shows poor retention of Pediatric Advanced Life Support provider skills. Frequent refresher training and in situ simulation are promising interventions. We developed a "Pediatric Advanced Life Support-reconstructed" recertification course by deconstructing the training into six 30-minute in situ simulation scenario sessions delivered over 6 months. We hypothesized that in situ Pediatric Advanced Life Support-reconstructed implementation is feasible and as effective as standard Pediatric Advanced Life Support recertification. A prospective randomized, single-blinded trial. Single-center, large, tertiary PICU in a university-affiliated children's hospital. Nurses and respiratory therapists in PICU. Simulation-based modular Pediatric Advanced Life Support recertification training. Simulation-based pre- and postassessment sessions were conducted to evaluate participants' performance. Video-recorded sessions were rated by trained raters blinded to allocation. The primary outcome was skill performance measured by a validated Clinical Performance Tool, and secondary outcome was behavioral performance measured by a Behavioral Assessment Tool. A mixed-effect model was used to account for baseline differences. Forty participants were prospectively randomized to Pediatric Advanced Life Support reconstructed versus standard Pediatric Advanced Life Support with no significant difference in demographics. Clinical Performance Tool score was similar at baseline in both groups and improved after Pediatric Advanced Life Support reconstructed (pre, 16.3 ± 4.1 vs post, 22.4 ± 3.9; p < 0.001), but not after standard Pediatric Advanced Life Support (pre, 14.3 ± 4.7 vs post, 14.9 ± 4.4; p =0.59). Improvement of Clinical Performance Tool was significantly higher in Pediatric Advanced Life Support reconstructed compared with standard Pediatric Advanced Life Support (p = 0.006). Behavioral Assessment Tool improved in both groups: Pediatric Advanced Life Support reconstructed (pre, 33.3 ± 4.5 vs post, 35.9 ± 5.0; p = 0.008) and standard Pediatric Advanced Life Support (pre, 30.5 ± 4.7 vs post, 33.6 ± 4.9; p = 0.02), with no significant difference of improvement between both groups (p = 0.49). For PICU-based nurses and respiratory therapists, simulation-based "Pediatric Advanced Life Support-reconstructed" in situ training is feasible and more effective than standard Pediatric Advanced Life Support recertification training for skill performance. Both Pediatric Advanced Life Support recertification training courses improved behavioral performance.

Competency Based Training. How To Do It--for Trainers. A Guide for Teachers and Trainers on Approaches to Competency Based Training.

ERIC Educational Resources Information Center

Worsnop, Percy J.

This booklet, which is intended for vocational educators/trainers in Australia, explains the principles and techniques of competency-based training (CBT). The following topics are discussed in the first 10 sections: the decision to adopt CBT in Australia; the meaning of competency; teaching and learning to become competent (competency standards as…

Gathering Information from Transport Systems for Processing in Supply Chains

NASA Astrophysics Data System (ADS)

Kodym, Oldřich; Unucka, Jakub

2016-12-01

Paper deals with complex system for processing information from means of transport acting as parts of train (rail or road). It focuses on automated information gathering using AutoID technology, information transmission via Internet of Things networks and information usage in information systems of logistic firms for support of selected processes on MES and ERP levels. Different kinds of gathered information from whole transport chain are discussed. Compliance with existing standards is mentioned. Security of information in full life cycle is integral part of presented system. Design of fully equipped system based on synthesized functional nodes is presented.

Comparison of two simulation systems to support robotic-assisted surgical training: a pilot study (Swine model).

PubMed

Whitehurst, Sabrina V; Lockrow, Ernest G; Lendvay, Thomas S; Propst, Anthony M; Dunlow, Susan G; Rosemeyer, Christopher J; Gobern, Joseph M; White, Lee W; Skinner, Anna; Buller, Jerome L

2015-01-01

To compare the efficacy of simulation-based training between the Mimic dV- Trainer and traditional dry lab da Vinci robot training. A prospective randomized study analyzing the performance of 20 robotics-naive participants. Participants were enrolled in an online da Vinci Intuitive Surgical didactic training module, followed by training in use of the da Vinci standard surgical robot. Spatial ability tests were performed as well. Participants were randomly assigned to 1 of 2 training conditions: performance of 3 Fundamentals of Laparoscopic Surgery dry lab tasks using the da Vinci or performance of 4 dV-Trainer tasks. Participants in both groups performed all tasks to empirically establish proficiency criterion. Participants then performed the transfer task, a cystotomy closure using the daVinci robot on a live animal (swine) model. The performance of robotic tasks was blindly assessed by a panel of experienced surgeons using objective tracking data and using the validated Global Evaluative Assessment of Robotic Surgery (GEARS), a structured assessment tool. No statistically significant difference in surgeon performance was found between the 2 training conditions, dV-Trainer and da Vinci robot. Analysis of a 95% confidence interval for the difference in means (-0.803 to 0.543) indicated that the 2 methods are unlikely to differ to an extent that would be clinically meaningful. Based on the results of this study, a curriculum on the dV- Trainer was shown to be comparable to traditional da Vinci robot training. Therefore, we have identified that training on a virtual reality system may be an alternative to live animal training for future robotic surgeons. Published by Elsevier Inc.

Perk Station – Percutaneous Surgery Training and Performance Measurement Platform

PubMed Central

Vikal, Siddharth; U-Thainual, Paweena; Carrino, John A.; Iordachita, Iulian; Fischer, Gregory S.; Fichtinger, Gabor

2009-01-01

Motivation Image-guided percutaneous (through the skin) needle-based surgery has become part of routine clinical practice in performing procedures such as biopsies, injections and therapeutic implants. A novice physician typically performs needle interventions under the supervision of a senior physician; a slow and inherently subjective training process that lacks objective, quantitative assessment of the surgical skill and performance[S1]. Shortening the learning curve and increasing procedural consistency are important factors in assuring high-quality medical care. Methods This paper describes a laboratory validation system, called Perk Station, for standardized training and performance measurement under different assistance techniques for needle-based surgical guidance systems. The initial goal of the Perk Station is to assess and compare different techniques: 2D image overlay, biplane laser guide, laser protractor and conventional freehand. The main focus of this manuscript is the planning and guidance software system developed on the 3D Slicer platform, a free, open source software package designed for visualization and analysis of medical image data. Results The prototype Perk Station has been successfully developed, the associated needle insertion phantoms were built, and the graphical user interface was fully implemented. The system was inaugurated in undergraduate teaching and a wide array of outreach activities. Initial results, experiences, ongoing activities and future plans are reported. PMID:19539446

Effect of information literacy training course on information literacy skills of undergraduate students of Isfahan University of Medical Sciences based on ACRL standards

PubMed Central

Karimi, Zohreh; Ashrafi-rizi, Hasan; Papi, Ahmad; Shahrzadi, Leila; Hassanzadeh, Akbar

2015-01-01

Background: Information literacy is the basis for lifelong learning. Information literacy skills, especially for student in an environment that is full of information from multiple technologies are being developed is equally important. Information literacy is a set of cognitive and practical skills and like any other science, proper training is needed, and standard-based education is definitely better and evaluation would be easier. This study aimed to determine the impact of information literacy training course on information literacy skills of Isfahan University of Medical Sciences students based on ACRL standard in 2012. Materials and Methods: The study method is semi-experience with two group design (with pre-test and post-test) and applied. The data collection toll was a questionnaire assessing student's information literacy that developed by Davarpanah and Siamak and validity was confirmed by professional librarians and reliability as measured by Cronbach's alpha, was 0.83. The sample consisted of 50 undergraduate students from Isfahan University of Medical Sciences that by random sampling method was perch in both case and control groups. Before and after the training (once a week), a questionnaire was distributed between the two groups. This training was held in a classroom equipped with computers with internet access and in addition to training using brochures and librarian presentation, interactive methods such as discussion and exercises were used. The data were analyzed using SPSS version 20 software and two level of descriptive (mean and SD) and inferential statistics (t-test and t-paired). Results: The results showed that the students’ information literacy scores before the training was lower than average, so that in the control group was 32.96 and in the case group was 33.24; while information literacy scores in the case group significantly increased after the training (46.68). Also, the effect of education, respectively had a greater impact on the ability to access information (the second standard), ethics and legal use of information (the third standard), effective use of information (the fourth standard), critically evaluate information and its sources (the fifth standard). Conclusion: This study showed that the training was effective on enhancing students’ information literacy skills as the greatest impact was on increasing the ability to access information. Due to low mean score information literacy in the context of object recognition, there is a need for more training in this area. PMID:27462618

Development of a health care systems curriculum

PubMed Central

Pruitt, Zachary; Mhaskar, Rahul; Kane, Bryan G; Barraco, Robert D; DeWaay, Deborah J; Rosenau, Alex M; Bresnan, Kristin A; Greenberg, Marna Rayl

2017-01-01

Background There is currently no gold standard for delivery of systems-based practice in medical education, and it is challenging to incorporate into medical education. Health systems competence requires physicians to understand patient care within the broader health care system and is vital to improving the quality of care clinicians provide. We describe a health systems curriculum that utilizes problem-based learning across 4 years of systems-based practice medical education at a single institution. Methods This case study describes the application of a problem-based learning approach to system-based practice medical education. A series of behavioral statements, called entrustable professional activities, was created to assess student health system competence. Student evaluation of course curriculum design, delivery, and assessment was provided through web-based surveys. Results To meet competency standards for system-based practice, a health systems curriculum was developed and delivered across 4 years of medical school training. Each of the health system lectures and problem-based learning activities are described herein. The majority of first and second year medical students stated they gained working knowledge of health systems by engaging in these sessions. The majority of the 2016 graduating students (88.24%) felt that the course content, overall, prepared them for their career. Conclusion A health systems curriculum in undergraduate medical education using a problem-based learning approach is feasible. The majority of students learning health systems curriculum through this format reported being prepared to improve individual patient care and optimize the health system’s value (better care and health for lower cost). PMID:29138614

Classification of weld defect based on information fusion technology for radiographic testing system

DOE Office of Scientific and Technical Information (OSTI.GOV)

Jiang, Hongquan; Liang, Zeming, E-mail: heavenlzm@126.com; Gao, Jianmin

Improving the efficiency and accuracy of weld defect classification is an important technical problem in developing the radiographic testing system. This paper proposes a novel weld defect classification method based on information fusion technology, Dempster–Shafer evidence theory. First, to characterize weld defects and improve the accuracy of their classification, 11 weld defect features were defined based on the sub-pixel level edges of radiographic images, four of which are presented for the first time in this paper. Second, we applied information fusion technology to combine different features for weld defect classification, including a mass function defined based on the weld defectmore » feature information and the quartile-method-based calculation of standard weld defect class which is to solve a sample problem involving a limited number of training samples. A steam turbine weld defect classification case study is also presented herein to illustrate our technique. The results show that the proposed method can increase the correct classification rate with limited training samples and address the uncertainties associated with weld defect classification.« less

Classification of weld defect based on information fusion technology for radiographic testing system.

PubMed

Jiang, Hongquan; Liang, Zeming; Gao, Jianmin; Dang, Changying

2016-03-01

Improving the efficiency and accuracy of weld defect classification is an important technical problem in developing the radiographic testing system. This paper proposes a novel weld defect classification method based on information fusion technology, Dempster-Shafer evidence theory. First, to characterize weld defects and improve the accuracy of their classification, 11 weld defect features were defined based on the sub-pixel level edges of radiographic images, four of which are presented for the first time in this paper. Second, we applied information fusion technology to combine different features for weld defect classification, including a mass function defined based on the weld defect feature information and the quartile-method-based calculation of standard weld defect class which is to solve a sample problem involving a limited number of training samples. A steam turbine weld defect classification case study is also presented herein to illustrate our technique. The results show that the proposed method can increase the correct classification rate with limited training samples and address the uncertainties associated with weld defect classification.

Regional approach to building operational level capacity for disaster planning: the case of the Eastern Africa region.

PubMed

Bazeyo, W; Mayega, R W; Orach, G C; Kiguli, J; Mamuya, S; Tabu, J S; Sena, L; Rugigana, E; Mapatano, M; Lewy, D; Mock, N; Burnham, G; Keim, M; Killewo, J

2013-06-01

The Eastern Africa region is regularly affected by a variety of disasters ranging from drought, to human conflict and population displacement. The magnitude of emergencies and response capacities is similar across the region. In order to strengthen public health disaster management capacities at the operational level in six countries of the Eastern Africa region, the USAID-funded leadership project worked through the HEALTH Alliance, a network of seven schools of public health from six countries in the region to train district-level teams. To develop a sustainable regional approach to building operational level capacity for disaster planning. This project was implemented through a higher education leadership initiative. Project activities were spear-headed by a network of Deans and Directors of public health schools within local universities in the Eastern Africa region. The leadership team envisioned a district-oriented systems change strategy. Pre-service and in-service curricula were developed regionally and district teams were formed to attend short training courses. Project activities began with a situational analysis of the disaster management capacity at national and operational levels. The next steps were chronologically the formation of country training teams and training of trainers, the development of a regional disaster management training curriculum and training materials, the cascading of training activities in the region, and the incorporation of emerging issues into the training curriculum. An evaluation model included the analysis of preparedness impact of the training program. The output from the district teams was the creation of individual district-level disaster plans and their implementation. This 4-year project focused on building operational level public health emergency response capacity, which had not previously been part of any national program. Use of the all-hazard approach rather than a scenario-based contingency planning led to the development of a standardized curriculum for training both in-service and pre-service personnel. Materials developed during the implementation phases of the project have been incorporated into public health graduate curricula in the seven schools. This systems-based strategy resulted in demonstrable outcomes related to district preparedness and university engagement in disaster management. University partnerships are an effective method to build district-level disaster planning capacity. Use of a regional network created a standardized approach across six countries.

20 CFR 619.4 - Data exchange standardization for the UI Benefits and Tax Systems.

Code of Federal Regulations, 2014 CFR

2014-04-01

... Benefits and Tax Systems. 619.4 Section 619.4 Employees' Benefits EMPLOYMENT AND TRAINING ADMINISTRATION... § 619.4 Data exchange standardization for the UI Benefits and Tax Systems. (a) XML is the data exchange standard for the real time ICON applications set out in § 619.2 and for the SIDES exchanges set out in...

The Effect of Online Systems Analysis Training on Aerospace Industry Business Performance: A Qualitative Study

ERIC Educational Resources Information Center

Burk, Erlan

2012-01-01

Aerospace companies needed additional research on technology-based training to verify expectations when enhancing human capital through online systems analysis training. The research for online systems analysis training provided aerospace companies a means to verify expectations for systems analysis technology-based training on business…

Classroom versus Computer-Based CPR Training: A Comparison of the Effectiveness of Two Instructional Methods

ERIC Educational Resources Information Center

Rehberg, Robb S.; Gazzillo Diaz, Linda; Middlemas, David A.

2009-01-01

Objective: The objective of this study was to determine whether computer-based CPR training is comparable to traditional classroom training. Design and Setting: This study was quantitative in design. Data was gathered from a standardized examination and skill performance evaluation which yielded numerical scores. Subjects: The subjects were 64…

Nephrology training curriculum and implications for optimal kidney care in the developing world.

PubMed

Okel, Julius; Okpechi, Ike G; Qarni, Bilal; Olanrewaju, Timothy; Courtney, Mark J; Luyckx, Valerie; Naicker, Sarala; Bello, Aminu K

An effective workforce is essential for delivery of high-quality chronic disease care. Low-income nations are challenged by a dearth and/or maldistribution of an essential workforce required for all chronic disease care including chronic kidney disease (CKD). Nephrology education and training in developed countries have grown at pace with the technological advancement in the practice of medicine in order to meet the standards required of kidney health professionals towards high-quality, patient-centered medical care. The standards designed by institutions and/or professional societies, such as Royal Colleges and Medical Councils in high-income nations with well-developed health systems and infrastructures, are often not easily translatable to issues critical to nephrology practice in low-income nations. Little or no guidance is provided on common nephrological issues of regional nature or pertaining to ethnic minorities and disadvantaged groups living in those countries. There is an emergent need for a training curriculum that meets the needs and peculiarities of the developing nations, and this needs to leverage on the existing and well-validated systems of training across the globe. We evaluated nephrology training programs across 25 upper-middle and high-income nations to identify best practices and opportunities for adoption in low-income nations. We reviewed training guidelines from major professional societies on content and process of training. There are similarities and differences in structure, content, and process of training programs across countries, and there are clearly adoptable concepts/frameworks for application in low-income nations. We provide recommendations and a strategic plan for the future focus of nephrology training in the developing world to align with current trends in technological advancement and development as well as the need for emphasis on prevention of CKD. The essential competencies (patient- and population--based) required of a nephrologist in a developing world setting are outlined with practical measures and an action plan for adoption.

Field performance of a low-cost and fully-automated blood counting system operated by trained and untrained users (Conference Presentation)

NASA Astrophysics Data System (ADS)

Xie, Dengling; Xie, Yanjun; Liu, Peng; Tong, Lieshu; Chu, Kaiqin; Smith, Zachary J.

2017-02-01

Current flow-based blood counting devices require expensive and centralized medical infrastructure and are not appropriate for field use. In this paper we report a method to count red blood cells, white blood cells as well as platelets through a low-cost and fully-automated blood counting system. The approach consists of using a compact, custom-built microscope with large field-of-view to record bright-field and fluorescence images of samples that are diluted with a single, stable reagent mixture and counted using automatic algorithms. Sample collection is performed manually using a spring loaded lancet, and volume-metering capillary tubes. The capillaries are then dropped into a tube of pre-measured reagents and gently shaken for 10-30 seconds. The sample is loaded into a measurement chamber and placed on a custom 3D printed platform. Sample translation and focusing is fully automated, and a user has only to press a button for the measurement and analysis to commence. Cost of the system is minimized through the use of custom-designed motorized components. We performed a series of comparative experiments by trained and untrained users on blood from adults and children. We compare the performance of our system, as operated by trained and untrained users, to the clinical gold standard using a Bland-Altman analysis, demonstrating good agreement of our system to the clinical standard. The system's low cost, complete automation, and good field performance indicate that it can be successfully translated for use in low-resource settings where central hematology laboratories are not accessible.

The strategic use of standardized information exchange technology in a university health system.

PubMed

Cheng, Po-Hsun; Chen, Heng-Shuen; Lai, Feipei; Lai, Jin-Shin

2010-04-01

This article illustrates a Web-based health information system that is comprised of specific information exchange standards related to health information for healthcare services in National Taiwan University Health System. Through multidisciplinary teamwork, medical and informatics experts collaborated and studied on system scope definition, standard selection challenges, system implementation barriers, system management outcomes, and further expandability of other systems. After user requirement analysis and prototyping, from 2005 to 2008, an online clinical decision support system with multiple functions of reminding and information push was implemented. It was to replace its original legacy systems and serve among the main hospital and three branches of 180-200 clinics and 7,500-8,000 patient visits per day. To evaluate the effectiveness of this system, user surveys were performed, which revealed that the average score of user satisfaction increased from 2.80 to 3.18 on a 4-point scale. Among the items, especially e-learning for training service, courtesy communications for system requests, and courtesy communications for system operations showed statistically significant improvement. From this study, the authors concluded that standardized information exchange technologies can be used to create a brand new enterprise value and steadily obtain more competitive advantages for a prestige healthcare system.

Mass detection in digital breast tomosynthesis: Deep convolutional neural network with transfer learning from mammography

PubMed Central

Chan, Heang-Ping; Hadjiiski, Lubomir; Helvie, Mark A.; Wei, Jun; Cha, Kenny

2016-01-01

Purpose: Develop a computer-aided detection (CAD) system for masses in digital breast tomosynthesis (DBT) volume using a deep convolutional neural network (DCNN) with transfer learning from mammograms. Methods: A data set containing 2282 digitized film and digital mammograms and 324 DBT volumes were collected with IRB approval. The mass of interest on the images was marked by an experienced breast radiologist as reference standard. The data set was partitioned into a training set (2282 mammograms with 2461 masses and 230 DBT views with 228 masses) and an independent test set (94 DBT views with 89 masses). For DCNN training, the region of interest (ROI) containing the mass (true positive) was extracted from each image. False positive (FP) ROIs were identified at prescreening by their previously developed CAD systems. After data augmentation, a total of 45 072 mammographic ROIs and 37 450 DBT ROIs were obtained. Data normalization and reduction of non-uniformity in the ROIs across heterogeneous data was achieved using a background correction method applied to each ROI. A DCNN with four convolutional layers and three fully connected (FC) layers was first trained on the mammography data. Jittering and dropout techniques were used to reduce overfitting. After training with the mammographic ROIs, all weights in the first three convolutional layers were frozen, and only the last convolution layer and the FC layers were randomly initialized again and trained using the DBT training ROIs. The authors compared the performances of two CAD systems for mass detection in DBT: one used the DCNN-based approach and the other used their previously developed feature-based approach for FP reduction. The prescreening stage was identical in both systems, passing the same set of mass candidates to the FP reduction stage. For the feature-based CAD system, 3D clustering and active contour method was used for segmentation; morphological, gray level, and texture features were extracted and merged with a linear discriminant classifier to score the detected masses. For the DCNN-based CAD system, ROIs from five consecutive slices centered at each candidate were passed through the trained DCNN and a mass likelihood score was generated. The performances of the CAD systems were evaluated using free-response ROC curves and the performance difference was analyzed using a non-parametric method. Results: Before transfer learning, the DCNN trained only on mammograms with an AUC of 0.99 classified DBT masses with an AUC of 0.81 in the DBT training set. After transfer learning with DBT, the AUC improved to 0.90. For breast-based CAD detection in the test set, the sensitivity for the feature-based and the DCNN-based CAD systems was 83% and 91%, respectively, at 1 FP/DBT volume. The difference between the performances for the two systems was statistically significant (p-value < 0.05). Conclusions: The image patterns learned from the mammograms were transferred to the mass detection on DBT slices through the DCNN. This study demonstrated that large data sets collected from mammography are useful for developing new CAD systems for DBT, alleviating the problem and effort of collecting entirely new large data sets for the new modality. PMID:27908154

Excellent reliability of the Hamilton Depression Rating Scale (HDRS-21) in Indonesia after training.

PubMed

Istriana, Erita; Kurnia, Ade; Weijers, Annelies; Hidayat, Teddy; Pinxten, Lucas; de Jong, Cor; Schellekens, Arnt

2013-09-01

The Hamilton Depression Rating Scale (HDRS) is the most widely used depression rating scale worldwide. Reliability of HDRS has been reported mainly from Western countries. The current study tested the reliability of HDRS ratings among psychiatric residents in Indonesia, before and after HDRS training. The hypotheses were that: (i) prior to the training reliability of HDRS ratings is poor; and (ii) HDRS training can improve reliability of HDRS ratings to excellent levels. Furthermore, we explored cultural validity at item level. Videotaped HDRS interviews were rated by 30 psychiatric residents before and after 1 day of HDRS training. Based on a gold standard rating, percentage correct ratings and deviation from the standard were calculated. Correct ratings increased from 83% to 99% at item level and from 70% to 100% for the total rating. The average deviation from the gold standard rating improved from 0.07 to 0.02 at item level and from 2.97 to 0.46 for the total rating. HDRS assessment by psychiatric trainees in Indonesia without prior training is unreliable. A short, evidence-based HDRS training improves reliability to near perfect levels. The outlined training program could serve as a template for HDRS trainings. HDRS items that may be less valid for assessment of depression severity in Indonesia are discussed. Copyright © 2013 Wiley Publishing Asia Pty Ltd.

Validation of a method for real time foot position and orientation tracking with Microsoft Kinect technology for use in virtual reality and treadmill based gait training programs.

PubMed

Paolini, Gabriele; Peruzzi, Agnese; Mirelman, Anat; Cereatti, Andrea; Gaukrodger, Stephen; Hausdorff, Jeffrey M; Della Croce, Ugo

2014-09-01

The use of virtual reality for the provision of motor-cognitive gait training has been shown to be effective for a variety of patient populations. The interaction between the user and the virtual environment is achieved by tracking the motion of the body parts and replicating it in the virtual environment in real time. In this paper, we present the validation of a novel method for tracking foot position and orientation in real time, based on the Microsoft Kinect technology, to be used for gait training combined with virtual reality. The validation of the motion tracking method was performed by comparing the tracking performance of the new system against a stereo-photogrammetric system used as gold standard. Foot position errors were in the order of a few millimeters (average RMSD from 4.9 to 12.1 mm in the medio-lateral and vertical directions, from 19.4 to 26.5 mm in the anterior-posterior direction); the foot orientation errors were also small (average %RMSD from 5.6% to 8.8% in the medio-lateral and vertical directions, from 15.5% to 18.6% in the anterior-posterior direction). The results suggest that the proposed method can be effectively used to track feet motion in virtual reality and treadmill-based gait training programs.

Intimate Partner Violence Programs in a Children's Hospital: Comprehensive Assessment Utilizing a Delphi Instrument.

PubMed

Randell, Kimberly A; Evans, Sarah E; O'Malley, Donna; Dowd, M Denise

2015-03-01

The purpose of this study was to conduct a baseline assessment of intimate partner violence (IPV) practices in a pediatric hospital system. The Delphi Instrument for Hospital-based Domestic Violence Programs was used to assess the structure and components of the hospital system's IPV practices. Through key stakeholder interviews, we also assessed IPV practices in individual patient care areas. Qualitative analysis of interview data used a grounded theory approach. The hospital scored 17 of 100 points on the Delphi instrument assessment. Key areas of weakness identified by the Delphi instrument and interviews included lack of coordinated provider training and evaluation of IPV-related processes and no standards for IPV screening, safety assessment, and documentation. Most interviewees supported addressing IPV; all identified barriers to IPV screening at individual provider and institutional levels. Institutional barriers included lack of a standardized response to IPV disclosure, need for individualized screening protocols for different patient care settings, lack of standardized provider training, concerns about overextending social work resources, and lack of resources for hospital staff experiencing vicarious trauma. Individual barriers included concern that screening may harm physician-patient-family relationships and the perception that physicians are unwilling to address psychosocial issues. The Delphi Instrument for Hospital-based Domestic Violence Programs identified weaknesses and key areas for improvement in IPV practices. Deficiencies revealed by the Delphi instrument were affirmed by individual interview results. Institutional and individual provider level barriers must be addressed to optimize IPV practices in a pediatric hospital system. Copyright © 2015 by the American Academy of Pediatrics.

Information Technology Training within Traineeships: Options for TAFE-Based Courses.

ERIC Educational Resources Information Center

Hall, W.; And Others

A study explored ways in which traineeship courses could be designed to include training in information technology. The skills and performance standards required of information technology training in the printing, tourism, banking, construction, and computer industries were identified. Next, the current provision of such training in Australia and…

Australian Recognition Framework Arrangements. Australia's National Training Framework.

ERIC Educational Resources Information Center

Australian National Training Authority, Brisbane.

This document explains the objectives, principles, standards, and protocols of the Australian Recognition Framework (ARF), which is a comprehensive approach to national recognition of vocational education and training (VET) that is based on a quality-assured approach to the registration of training organizations seeking to deliver training, assess…

Certification of training

NASA Technical Reports Server (NTRS)

Gibson, Richard S.

1994-01-01

Training has been around as an informal process for countless years. Most higher order animals require some level of training in hunting, social skills, or other survival related skills to continue their existence beyond early infancy. Much of the training is accomplished through imitation, trial and error, and good luck. In some ways the essentials of training in aviation have not deviated from this original formula a great deal. One of the major changes in aviation and other technical areas is that more complex response chains based on a broader base of knowledge are now required. 'To certify' means many things according to the American Heritage dictionary of the English Language. These meanings range from 'to guarantee as meeting a standard' to 'to declare legally insane'. For this discussion, we will use the definition 'an action taken by some authoritative body that essentially guarantees that the instruction meets some defined standard'. In order to make this certification, the responsible body subjects the educational process, training, training device, or simulator to some type of examination to determine its adequacy or validity.

4 CFR 2.4 - Merit system principles.

Code of Federal Regulations, 2011 CFR

2011-01-01

... recognition should be provided for excellence in performance. (4) All employees should maintain high standards... education and training in cases in which such education and training would result in better organizational...

Application of the "see one, do one, teach one" concept in surgical training.

PubMed

Kotsis, Sandra V; Chung, Kevin C

2013-05-01

The traditional method of teaching in surgery is known as "see one, do one, teach one." However, many have argued that this method is no longer applicable, mainly because of concerns for patient safety. The purpose of this article is to show that the basis of the traditional teaching method is still valid in surgical training if it is combined with various adult learning principles. The authors reviewed literature regarding the history of the formation of the surgical residency program, adult learning principles, mentoring, and medical simulation. The authors provide examples for how these learning techniques can be incorporated into a surgical resident training program. The surgical residency program created by Dr. William Halsted remained virtually unchanged until recently with reductions in resident work hours and changes to a competency-based training system. Such changes have reduced the teaching time between attending physicians and residents. Learning principles such as experience, observation, thinking, and action and deliberate practice can be used to train residents. Mentoring is also an important aspect in teaching surgical technique. The authors review the different types of simulators-standardized patients, virtual reality applications, and high-fidelity mannequin simulators-and the advantages and disadvantages of using them. The traditional teaching method of "see one, do one, teach one" in surgical residency programs is simple but still applicable. It needs to evolve with current changes in the medical system to adequately train surgical residents and also provide patients with safe, evidence-based care.

The LET Procedure for Prosthetic Myocontrol: Towards Multi-DOF Control Using Single-DOF Activations.

PubMed

Nowak, Markus; Castellini, Claudio

2016-01-01

Simultaneous and proportional myocontrol of dexterous hand prostheses is to a large extent still an open problem. With the advent of commercially and clinically available multi-fingered hand prostheses there are now more independent degrees of freedom (DOFs) in prostheses than can be effectively controlled using surface electromyography (sEMG), the current standard human-machine interface for hand amputees. In particular, it is uncertain, whether several DOFs can be controlled simultaneously and proportionally by exclusively calibrating the intended activation of single DOFs. The problem is currently solved by training on all required combinations. However, as the number of available DOFs grows, this approach becomes overly long and poses a high cognitive burden on the subject. In this paper we present a novel approach to overcome this problem. Multi-DOF activations are artificially modelled from single-DOF ones using a simple linear combination of sEMG signals, which are then added to the training set. This procedure, which we named LET (Linearly Enhanced Training), provides an augmented data set to any machine-learning-based intent detection system. In two experiments involving intact subjects, one offline and one online, we trained a standard machine learning approach using the full data set containing single- and multi-DOF activations as well as using the LET-augmented data set in order to evaluate the performance of the LET procedure. The results indicate that the machine trained on the latter data set obtains worse results in the offline experiment compared to the full data set. However, the online implementation enables the user to perform multi-DOF tasks with almost the same precision as single-DOF tasks without the need of explicitly training multi-DOF activations. Moreover, the parameters involved in the system are statistically uniform across subjects.

Advanced real-time multi-display educational system (ARMES): An innovative real-time audiovisual mentoring tool for complex robotic surgery.

PubMed

Lee, Joong Ho; Tanaka, Eiji; Woo, Yanghee; Ali, Güner; Son, Taeil; Kim, Hyoung-Il; Hyung, Woo Jin

2017-12-01

The recent scientific and technologic advances have profoundly affected the training of surgeons worldwide. We describe a novel intraoperative real-time training module, the Advanced Robotic Multi-display Educational System (ARMES). We created a real-time training module, which can provide a standardized step by step guidance to robotic distal subtotal gastrectomy with D2 lymphadenectomy procedures, ARMES. The short video clips of 20 key steps in the standardized procedure for robotic gastrectomy were created and integrated with TilePro™ software to delivery on da Vinci Surgical Systems (Intuitive Surgical, Sunnyvale, CA). We successfully performed the robotic distal subtotal gastrectomy with D2 lymphadenectomy for patient with gastric cancer employing this new teaching method without any transfer errors or system failures. Using this technique, the total operative time was 197 min and blood loss was 50 mL and there were no intra- or post-operative complications. Our innovative real-time mentoring module, ARMES, enables standardized, systematic guidance during surgical procedures. © 2017 Wiley Periodicals, Inc.

Changing the Learning Environment in the College of Engineering and Applied Science: The impact of Educational Training on Future Faculty and Student- Centered Pedagogy on Undergraduate Students

NASA Astrophysics Data System (ADS)

Gaskins, Whitney

Over the past 20 years there have been many changes to the primary and secondary educational system that have impacted students, teachers, and post-secondary institutions across the United States of America. One of the most important is the large number of standardized tests students are required to take to show adequate performance in school. Students think differently because they are taught differently due to this focus on standardized testing, thus changing the skill sets students acquire in secondary school. This presents a critical problem for colleges and universities, as they now are using practices for and have expectations of these students that are unrealistic for the changing times. High dropout rates in the College of Engineering have been attributed to the cultural atmosphere of the institution. Students have reported a low sense of belonging and low relatability to course material. This study developed a "preparing the future" faculty program that gave graduate students at the University of Cincinnati a unique training experience that helped them understand the students they will educate. They received educational training, developed from a future educator's curriculum that covered classroom management, standards, and pedagogy. Graduate students who participated in the training program reported increases in self-efficacy and student understanding. To reduce negative experiences and increase motivation, Challenge Based Learning (CBL) was introduced in an undergraduate Basic Electric Circuits (BEC) course. CBL is a structured model for course content with a foundation in problem-based learning. CBL offers general concepts from which students derive the challenges they will address. Results show an improved classroom experience for students who were taught with CBL.

Effects of computer-based training on procedural modifications to standard functional analyses.

PubMed

Schnell, Lauren K; Sidener, Tina M; DeBar, Ruth M; Vladescu, Jason C; Kahng, SungWoo

2018-01-01

Few studies have evaluated methods for training decision-making when functional analysis data are undifferentiated. The current study evaluated computer-based training to teach 20 graduate students to arrange functional analysis conditions, analyze functional analysis data, and implement procedural modifications. Participants were exposed to training materials using interactive software during a 1-day session. Following the training, mean scores on the posttest, novel cases probe, and maintenance probe increased for all participants. These results replicate previous findings during a 1-day session and include a measure of participant acceptability of the training. Recommendations for future research on computer-based training and functional analysis are discussed. © 2017 Society for the Experimental Analysis of Behavior.

Qualitative and quantitative outcomes of audience response systems as an educational tool in a plastic surgery residency program.

PubMed

Arneja, Jugpal S; Narasimhan, Kailash; Bouwman, David; Bridge, Patrick D

2009-12-01

In-training evaluations in graduate medical education have typically been challenging. Although the majority of standardized examination delivery methods have become computer-based, in-training examinations generally remain pencil-paper-based, if they are performed at all. Audience response systems present a novel way to stimulate and evaluate the resident-learner. The purpose of this study was to assess the outcomes of audience response systems testing as compared with traditional testing in a plastic surgery residency program. A prospective 1-year pilot study of 10 plastic surgery residents was performed using audience response systems-delivered testing for the first half of the academic year and traditional pencil-paper testing for the second half. Examination content was based on monthly "Core Quest" curriculum conferences. Quantitative outcome measures included comparison of pretest and posttest and cumulative test scores of both formats. Qualitative outcomes from the individual participants were obtained by questionnaire. When using the audience response systems format, pretest and posttest mean scores were 67.5 and 82.5 percent, respectively; using traditional pencil-paper format, scores were 56.5 percent and 79.5 percent. A comparison of the cumulative mean audience response systems score (85.0 percent) and traditional pencil-paper score (75.0 percent) revealed statistically significantly higher scores with audience response systems (p = 0.01). Qualitative outcomes revealed increased conference enthusiasm, greater enjoyment of testing, and no user difficulties with the audience response systems technology. The audience response systems modality of in-training evaluation captures participant interest and reinforces material more effectively than traditional pencil-paper testing does. The advantages include a more interactive learning environment, stimulation of class participation, immediate feedback to residents, and immediate tabulation of results for the educator. Disadvantages include start-up costs and lead-time preparation.

Multivendor Spectral-Domain Optical Coherence Tomography Dataset, Observer Annotation Performance Evaluation, and Standardized Evaluation Framework for Intraretinal Cystoid Fluid Segmentation.

PubMed

Wu, Jing; Philip, Ana-Maria; Podkowinski, Dominika; Gerendas, Bianca S; Langs, Georg; Simader, Christian; Waldstein, Sebastian M; Schmidt-Erfurth, Ursula M

2016-01-01

Development of image analysis and machine learning methods for segmentation of clinically significant pathology in retinal spectral-domain optical coherence tomography (SD-OCT), used in disease detection and prediction, is limited due to the availability of expertly annotated reference data. Retinal segmentation methods use datasets that either are not publicly available, come from only one device, or use different evaluation methodologies making them difficult to compare. Thus we present and evaluate a multiple expert annotated reference dataset for the problem of intraretinal cystoid fluid (IRF) segmentation, a key indicator in exudative macular disease. In addition, a standardized framework for segmentation accuracy evaluation, applicable to other pathological structures, is presented. Integral to this work is the dataset used which must be fit for purpose for IRF segmentation algorithm training and testing. We describe here a multivendor dataset comprised of 30 scans. Each OCT scan for system training has been annotated by multiple graders using a proprietary system. Evaluation of the intergrader annotations shows a good correlation, thus making the reproducibly annotated scans suitable for the training and validation of image processing and machine learning based segmentation methods. The dataset will be made publicly available in the form of a segmentation Grand Challenge.

Multivendor Spectral-Domain Optical Coherence Tomography Dataset, Observer Annotation Performance Evaluation, and Standardized Evaluation Framework for Intraretinal Cystoid Fluid Segmentation

PubMed Central

Wu, Jing; Philip, Ana-Maria; Podkowinski, Dominika; Gerendas, Bianca S.; Langs, Georg; Simader, Christian

2016-01-01

Development of image analysis and machine learning methods for segmentation of clinically significant pathology in retinal spectral-domain optical coherence tomography (SD-OCT), used in disease detection and prediction, is limited due to the availability of expertly annotated reference data. Retinal segmentation methods use datasets that either are not publicly available, come from only one device, or use different evaluation methodologies making them difficult to compare. Thus we present and evaluate a multiple expert annotated reference dataset for the problem of intraretinal cystoid fluid (IRF) segmentation, a key indicator in exudative macular disease. In addition, a standardized framework for segmentation accuracy evaluation, applicable to other pathological structures, is presented. Integral to this work is the dataset used which must be fit for purpose for IRF segmentation algorithm training and testing. We describe here a multivendor dataset comprised of 30 scans. Each OCT scan for system training has been annotated by multiple graders using a proprietary system. Evaluation of the intergrader annotations shows a good correlation, thus making the reproducibly annotated scans suitable for the training and validation of image processing and machine learning based segmentation methods. The dataset will be made publicly available in the form of a segmentation Grand Challenge. PMID:27579177

Artificial Neural Network Approach in Laboratory Test Reporting:  Learning Algorithms.

PubMed

Demirci, Ferhat; Akan, Pinar; Kume, Tuncay; Sisman, Ali Riza; Erbayraktar, Zubeyde; Sevinc, Suleyman

2016-08-01

In the field of laboratory medicine, minimizing errors and establishing standardization is only possible by predefined processes. The aim of this study was to build an experimental decision algorithm model open to improvement that would efficiently and rapidly evaluate the results of biochemical tests with critical values by evaluating multiple factors concurrently. The experimental model was built by Weka software (Weka, Waikato, New Zealand) based on the artificial neural network method. Data were received from Dokuz Eylül University Central Laboratory. "Training sets" were developed for our experimental model to teach the evaluation criteria. After training the system, "test sets" developed for different conditions were used to statistically assess the validity of the model. After developing the decision algorithm with three iterations of training, no result was verified that was refused by the laboratory specialist. The sensitivity of the model was 91% and specificity was 100%. The estimated κ score was 0.950. This is the first study based on an artificial neural network to build an experimental assessment and decision algorithm model. By integrating our trained algorithm model into a laboratory information system, it may be possible to reduce employees' workload without compromising patient safety. © American Society for Clinical Pathology, 2016. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

The appropriateness of training exposures for match-play preparation in adolescent schoolboy and academy rugby union players.

PubMed

Phibbs, Padraic J; Jones, Ben; Read, Dale B; Roe, Gregory A B; Darrall-Jones, Joshua; Weakley, Jonathon J S; Rock, Andrew; Till, Kevin

2018-03-01

The aim of this study was to compare the physical and movement demands between training and match-play in schoolboy and academy adolescent rugby union (RU) players. Sixty-one adolescent male RU players (mean ± SD; age 17.0 ± 0.7 years) were recruited from four teams representing school and regional academy standards. Players were categorised into four groups based on playing standard and position: schoolboy forwards (n = 15), schoolboy backs (n = 15), academy forwards (n = 16) and academy backs (n = 15). Global positioning system and accelerometry measures were obtained from training and match-play to assess within-group differences between conditions. Maximum data were analysed from 79 match files across 8 matches (1.3 ± 0.5 matches per participant) and 152 training files across 15 training sessions (2.5 ± 0.5 training sessions per participant). Schoolboy forwards were underprepared for low-intensity activities experienced during match-play, with schoolboy backs underprepared for all movement demands. Academy forwards were exposed to similar physical demands in training to matches, with academy backs similar to or exceeding values for all measured variables. Schoolboy players were underprepared for many key, position-specific aspects of match-play, which could place them at greater risk of injury and hinder performance, unlike academy players who were better prepared.

7 CFR 274.12 - Electronic Benefit Transfer issuance system approval standards.

Code of Federal Regulations, 2010 CFR

2010-01-01

... are trained in system operation prior to implementation. Retailer training shall be offered by the... paragraph at customer service booths or other locations if appropriate. (5) The State agency shall ensure... AND NUTRITION SERVICE, DEPARTMENT OF AGRICULTURE FOOD STAMP AND FOOD DISTRIBUTION PROGRAM ISSUANCE AND...

Training Substance Abuse Clinicians in Motivational Interviewing Using Live Supervision via Tele-conferencing

PubMed Central

Smith, Jennifer L.; Carpenter, Kenneth M.; Amrhein, Paul C.; Brooks, Adam C.; Levin, Deborah; Schreiber, Elizabeth A.; Travaglini, Laura A.; Hu, Mei-Chen; Nunes, Edward V.

2012-01-01

Background Training through traditional workshops is relatively ineffective for changing counseling practices. Tele-conferencing Supervision (TCS) was developed to provide remote, live supervision for training motivational interviewing (MI). Method 97 community drug treatment counselors completed a 2-day MI workshop and were randomized to: live supervision via tele-conferencing (TCS; n=32), standard tape-based supervision (Tape; n=32), or workshop alone (Workshop; n=33). Supervision conditions received 5 weekly supervision sessions at their sites using actors as standard patients. Sessions with clients were rated for MI skill with the Motivational Interviewing Treatment Integrity (MITI) coding system pre-workshop and 1, 8, and 20 weeks post-workshop. Mixed effects linear models were used to test training condition on MI skill at 8 and 20 weeks. Results TCS scored better than Workshop on the MITI for Spirit (mean difference = 0.76; p < .0001; d = 1.01) and Empathy (mean difference = 0.68; p < .001; d = 0.74). Tape supervision fell between TCS and Workshop, with Tape superior to Workshop for Spirit (mean difference = 0.40; p < .05). TCS was superior to Workshop in reducing MI non-adherence and increasing MI adherence, and was superior to Workshp and Tape in increasing the reflection to question ratio. Tape was superior to TCS in increasing complex reflections. Percentage of counselors meeting proficiency differed significantly between training conditions for the most stringent threshold (Spirit and Empathy scores ≥ 6), and were modest, ranging from 13% to 67%, for TCS and Tape. Conclusion TCS shows promise for promoting new counseling behaviors following participation in workshop training. However, further work is needed to improve supervision methods in order to bring more clinicians to high levels of proficiency and facilitate the dissemination of evidence-based practices. PMID:22506795

T and D Publications. Volume 13, Number 8.

ERIC Educational Resources Information Center

International Labour Office, Geneva (Switzerland).

The eighth dispatch contains abstracts of publications from all over the world which focus on vocational education and training development. The first section, News in Brief, consists of 37 abstracts presented under the following topics: forthcoming events, new policies, new institutions, training systems development, training standards,…

49 CFR 236.516 - Power supply.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 49 Transportation 4 2011-10-01 2011-10-01 false Power supply. 236.516 Section 236.516..., Train Control and Cab Signal Systems Standards § 236.516 Power supply. Automatic cab signal, train stop, or train control device hereafter installed shall operate from a separate or isolated power supply...

49 CFR 236.516 - Power supply.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 49 Transportation 4 2010-10-01 2010-10-01 false Power supply. 236.516 Section 236.516..., Train Control and Cab Signal Systems Standards § 236.516 Power supply. Automatic cab signal, train stop, or train control device hereafter installed shall operate from a separate or isolated power supply...

Survey and analysis of the current state of residency training in medical-school-affiliated hospitals in China

PubMed Central

2014-01-01

Background Since the global standards for postgraduate medical education (PGME) were published in January 2003, they have gained worldwide attention. The current state of residency training programs in medical-school-affiliated hospitals throughout China was assessed in this study. Methods Based on the internationally recognized global standards for PGME, residents undergoing residency training at that time and the relevant residency training instructors and management personnel from 15 medical-school-affiliated hospitals throughout China were recruited and surveyed regarding the current state of residency training programs. A total of 938 questionnaire surveys were distributed between June 30, 2006 and July 30, 2006; of 892 surveys collected, 841 were valid. Results For six items, the total proportions of “basically meets standards” and “completely meets standards” were <70% for the basic standards. These items were identified in the fields of “training settings and educational resources”, “evaluation of training process”, and “trainees”. In all fields other than “continuous updates”, the average scores of the western regions were significantly lower than those of the eastern regions for both the basic and target standards. Specifically, the average scores for the basic standards on as many as 25 of the 38 items in the nine fields were significantly lower in the western regions. There were significant differences in the basic standards scores on 13 of the 38 items among trainees, instructors, and managers. Conclusions The residency training programs have achieved satisfactory outcomes in the hospitals affiliated with various medical schools in China. However, overall, the programs remain inadequate in certain areas. For the governments, organizations, and institutions responsible for PGME, such global standards for PGME are a very useful self-assessment tool and can help identify problems, promote reform, and ultimately standardize PGME. PMID:24885865

MACH 3: Past and future approaches to intelligent tutoring

NASA Technical Reports Server (NTRS)

Acchione-Noel, Sylvia; Psotka, Joseph

1993-01-01

In 1986, the U.S. Army Research Institute created an intelligent tutoring system as a proof-of-concept for artificial intelligence applications in Army training. The Maintenance Aid Computer HAWK Intelligent Institutional Instructor (MACH 3) taught student mechanics to maintain and troubleshoot the AN/MPQ-57 High Power Illuminator Radar (HPIR) of the HAWK Air Defense Missile System. In 1989, TRADOC Analysis Command compared the effectiveness of MACH 3 to traditional paper-based troubleshooting drills. For the study, all students received lecture and hands-on training as usual. However, during troubleshooting drills, students traced faults using either MACH 3 or the traditional paper-based method. Class records showed that the MACH 3 group completed significantly more troubleshooting tasks and progressed through tasks of greater difficulty than the paper-based group. Upon completion of training, students took written, practical, and oral essay tests. Mean test scores showed that students performed similarly regardless of the drill method used. However, significantly different standard deviations showed that the MACH 3 group performed more consistently than the paper-based group. Furthermore, significantly different time measures showed that the MACH 3 group reached faster troubleshooting solutions on the actual radar transmitter than the paper-based group. We will present the study results and discuss how updating the design of the MACH 3 can include desktop computing in a virtual environment.

Telelearning standards and their application in medical education.

PubMed

Duplaga, Mariusz; Juszkiewicz, Krzysztof; Leszczuk, Mikolaj

2004-01-01

Medial education, both on the graduate and postgraduate levels, has become a real challenge nowadays. The volume of information in medical sciences grows so rapidly that many health professionals experience essential problems in keeping track of the state of the art in this domain. e-learning offers important advantages to medical education continuation due to its universal availability and opportunity for implementation of flexible patterns of training. An important trace of medical education is developing practical skills. Some examples of standardization efforts include: the CEN/ISSS Workshop on Learning Technology (WSLT), the Advanced Learning Infrastructure Consortium (ALIC), Education Network Australia (EdNA) and PROmoting Multimedia access to Education and Training in European Society (PROMETEUS). Sun Microsystems' support (Sun ONE, iPlanetTM ) for many of the above-mentioned standards is described as well. Development of a medical digital video library with recordings of invasive procedures incorporating additional information and commentary may improve the efficiency of the training process in interventional medicine. A digital video library enabling access to videos of interventional procedures performed in the area of thoracic medicine may be a valuable element for developing practical skills. The library has been filled with video resources recorded at the Department of Interventional Pulmonology; it enhances training options for pulmonologists and thoracic surgeons. The main focus was put on demonstration of bronchofiberoscopic and videothoracoscopic procedures. The opportunity to browse video recordings of procedures performed in the specific field also considerably enhances the options for training in other medical specialties. In the era of growing health consumer awareness, patients are also perceived as the target audience for medical digital libraries. As a case study of Computer-Based Training systems, the Medical Digital Video Library is presented.

Virtual Reality Simulator Systems in Robotic Surgical Training.

PubMed

Mangano, Alberto; Gheza, Federico; Giulianotti, Pier Cristoforo

2018-06-01

The number of robotic surgical procedures has been increasing worldwide. It is important to maximize the cost-effectiveness of robotic surgical training and safely reduce the time needed for trainees to reach proficiency. The use of preliminary lab training in robotic skills is a good strategy for the rapid acquisition of further, standardized robotic skills. Such training can be done either by using a simulator or by exercises in a dry or wet lab. While the use of an actual robotic surgical system for training may be problematic (high cost, lack of availability), virtual reality (VR) simulators can overcome many of these obstacles. However, there is still a lack of standardization. Although VR training systems have improved, they cannot yet replace experience in a wet lab. In particular, simulated scenarios are not yet close enough to a real operative experience. Indeed, there is a difference between technical skills (i.e., mechanical ability to perform a simulated task) and surgical competence (i.e., ability to perform a real surgical operation). Thus, while a VR simulator can replace a dry lab, it cannot yet replace training in a wet lab or operative training in actual patients. However, in the near future, it is expected that VR surgical simulators will be able to provide total reality simulation and replace training in a wet lab. More research is needed to produce more wide-ranging, trans-specialty robotic curricula.

[Simulation-based training in anesthesia and emergency medicine: preparation for the unexpected: on the way to new standards of education in Germany].

PubMed

Issleib, Malte; Zöllner, C

2015-01-01

Medical expertise consists of knowledge, professional skills and individual attitudes. Training and education of this expertise starts in medical school and develops throughout the qualification process of anesthesists and emergency physicians. Medical decisions are not only rational but also intuitive. The combination of these characteristics cannot and should not be trained on patients. The implementation of modern simulation techniques offers the opportunity to train for emergency situations similar to training systems in the energy industry and aviation. Repetitive training of rare emergency situations brings routine to seldomly used procedures. In simulation training mistakes can be detected and systematically corrected. The team interactions and soft skills can also be focussed on. Video analysis gives the participant the opportunity for self-reflection and can lead to correction of individual behavior patterns. This dimension of education cannot be done in real patient care. This training goes far beyond the level of skills training. Through simulation training involves the whole team, the communication and the interaction between the team members in medically challenging situations. Crisis resource management leads to measurable improvements in patient safety and safety culture as well as personnel satisfaction.

Autonomous rehabilitation at stroke patients home for balance and gait: safety, usability and compliance of a virtual reality system.

PubMed

Held, Jeremia P; Ferrer, Begoña; Mainetti, Renato; Steblin, Alexander; Hertler, Benjamin; Moreno-Conde, Alberto; Dueñas, Alvaro; Pajaro, Marta; L-Parra-Calderón, Carlos; Vargiu, Eloisa; Zarco, Maria J; Barrera, Maria; Echevarria, Carmen; Jódar-Sánchez, Francisco; Luft, Andreas R; Borghese, Nunzio A

2017-09-25

New technologies, such as telerehabilitation and gaming devices offer the possibility for patients to train at home. This opens the challenge of safety for the patient as he is called to exercise neither with a therapist on the patients' side nor with a therapist linked remotely to supervise the sessions. To study the safety, usability and patient acceptance of an autonomous telerehabilitation system for balance and gait (the REWIRE platform) in the patients home. Cohort study. Community, in the stroke patients' home. 15 participants with first-ever stroke, with a mild to moderate residual deficit of the lower extremities. Autonomous rehabilitation based on virtual rehabilitation was provided at the participants' home for twelve weeks. The primary outcome was compliance (the ratio between days of actual and scheduled training), analysed with the two-tailed Wilcoxon Mann- Whitney test. Furthermore safety is defined by adverse events. The secondary endpoint was the acceptance of the system measured with the Technology Acceptance Model. Additionally, the cumulative duration of weekly training was analysed. During the study there were no adverse events related to the therapy. Patients performed on average 71% (range 39 to 92%) of the scheduled sessions. The Technology Acceptance Model Questionnaire showed excellent values for stroke patients after the training. The average training duration per week was 99 ±53min. Autonomous telerehabilitation for balance and gait training with the REWIRE-system is safe, feasible and can help to intensive rehabilitative therapy at home. Telerehabilitation enables safe training in home environment and supports of the standard rehabilitation therapy.

Solar System Educators Program

NASA Astrophysics Data System (ADS)

Knudsen, R.

2004-11-01

The Solar System Educators Program is a nationwide network of highly motivated teachers who lead workshops that show other teachers in their local communities how to successfully incorporate NASA materials and research into their classes. Currently there are 57 Solar System Educators in 37 states whose workshops are designed to assist their fellow teachers in understanding and including standards-based NASA materials into their classroom activities. Solar System Educators attend a training institute during their first year in the program and have the option of attending subsequent annual institutes. The volunteers in this program receive additional web-based mission-specific telecon trainings in conjunction with the Solar System Ambassadors. Resource and handout materials in the form of DVDs, posters, pamphlets, fact sheets, postcards and bookmarks are also provided. Scientists can get involved with this program by partnering with the Solar System Educators in their regions, presenting at their workshops and mentoring these outstanding volunteers. This formal education program helps optimize project funding set aside for education through the efforts of these volunteer master teachers. At the same time, teachers become familiar with NASA's educational materials with which to inspire students into pursuing careers in science, technology, engineering and math.

[The System and Human Resources for Occupational Health in Thailand - For Japanese Enterprises to Manage Proper Occupational Health Activities at Overseas Workplaces].

PubMed

Fukai, Nanae; Hiraoka, Ko; Kajiki, Shigeyuki; Kobayashi, Yuichi; Thanachokswang, Chatchai; Arphorn, Sara; Uehara, Msamichi; Nakanishi, Shigemoto; Mori, Koji

We collected information necessary for conducting occupational health activities in Thailand with regard to occupational safety and health management systems (OSHMS). Based on an information collection check sheet developed in our previous research, we conducted a literature research and visited four local business bases, one ISO certification body and two higher educational institutions. The legal framework concerning occupational health in Thailand consists of the Occupational Safety, Health and Environment Act of 2011 and 13 ordinances from the Ministry of Labor under that act. The original OSHMS standards for Thailand have been published, and the number of companies, especially large ones, introducing systems conforming to these standards has increased in recent years. For occupational health specialists, there are training programs for specialized occupational health physicians, professional safety officers and occupational nurses. Professional safety officers also play a central role in occupational health in the workplace. In Thailand, it is necessary to ensure compliance with related acts and regulations, and to conduct voluntary activities that satisfy workplace conditions as based on the OSHMS standards. Additionally, to improve occupational health performance, it is essential to use high-quality external services and/or occupational health professionals. Headquarters of Japanese companies have considered taking countermeasures such as recommending active use of professional safety officers, as well as issuing global standards.

Benefits to the Simulation Training Community of a New ANSI Standard for the Exchange of Aero Simulation Models

NASA Technical Reports Server (NTRS)

Hildreth, Bruce L.; Jackson, E. Bruce

2009-01-01

The American Institute of Aeronautics Astronautics (AIAA) Modeling and Simulation Technical Committee is in final preparation of a new standard for the exchange of flight dynamics models. The standard will become an ANSI standard and is under consideration for submission to ISO for acceptance by the international community. The standard has some a spects that should provide benefits to the simulation training community. Use of the new standard by the training simulation community will reduce development, maintenance and technical refresh investment on each device. Furthermore, it will significantly lower the cost of performing model updates to improve fidelity or expand the envelope of the training device. Higher flight fidelity should result in better transfer of training, a direct benefit to the pilots under instruction. Costs of adopting the standard are minimal and should be paid back within the cost of the first use for that training device. The standard achie ves these advantages by making it easier to update the aerodynamic model. It provides a standard format for the model in a custom eXtensible Markup Language (XML) grammar, the Dynamic Aerospace Vehicle Exchange Markup Language (DAVE-ML). It employs an existing XML grammar, MathML, to describe the aerodynamic model in an input data file, eliminating the requirement for actual software compilation. The major components of the aero model become simply an input data file, and updates are simply new XML input files. It includes naming and axis system conventions to further simplify the exchange of information.

Automated Detection of Glaucoma From Topographic Features of the Optic Nerve Head in Color Fundus Photographs.

PubMed

Chakrabarty, Lipi; Joshi, Gopal Datt; Chakravarty, Arunava; Raman, Ganesh V; Krishnadas, S R; Sivaswamy, Jayanthi

2016-07-01

To describe and evaluate the performance of an automated CAD system for detection of glaucoma from color fundus photographs. Color fundus photographs of 2252 eyes from 1126 subjects were collected from 2 centers: Aravind Eye Hospital, Madurai and Coimbatore, India. The images of 1926 eyes (963 subjects) were used to train an automated image analysis-based system, which was developed to provide a decision on a given fundus image. A total of 163 subjects were clinically examined by 2 ophthalmologists independently and their diagnostic decisions were recorded. The consensus decision was defined to be the clinical reference (gold standard). Fundus images of eyes with disagreement in diagnosis were excluded from the study. The fundus images of the remaining 314 eyes (157 subjects) were presented to 4 graders and their diagnostic decisions on the same were collected. The performance of the system was evaluated on the 314 images, using the reference standard. The sensitivity and specificity of the system and 4 independent graders were determined against the clinical reference standard. The system achieved an area under receiver operating characteristic curve of 0.792 with a sensitivity of 0.716 and specificity of 0.717 at a selected threshold for the detection of glaucoma. The agreement with the clinical reference standard as determined by Cohen κ is 0.45 for the proposed system. This is comparable to that of the image-based decisions of 4 ophthalmologists. An automated system was presented for glaucoma detection from color fundus photographs. The overall evaluation results indicated that the presented system was comparable in performance to glaucoma classification by a manual grader solely based on fundus image examination.

Training system for digital mammographic diagnoses of breast cancer

NASA Astrophysics Data System (ADS)

Thomaz, R. L.; Nirschl Crozara, M. G.; Patrocinio, A. C.

2013-03-01

As the technology evolves, the analog mammography systems are being replaced by digital systems. The digital system uses video monitors as the display of mammographic images instead of the previously used screen-film and negatoscope for analog images. The change in the way of visualizing mammographic images may require a different approach for training the health care professionals in diagnosing the breast cancer with digital mammography. Thus, this paper presents a computational approach to train the health care professionals providing a smooth transition between analog and digital technology also training to use the advantages of digital image processing tools to diagnose the breast cancer. This computational approach consists of a software where is possible to open, process and diagnose a full mammogram case from a database, which has the digital images of each of the mammographic views. The software communicates with a gold standard digital mammogram cases database. This database contains the digital images in Tagged Image File Format (TIFF) and the respective diagnoses according to BI-RADSTM, these files are read by software and shown to the user as needed. There are also some digital image processing tools that can be used to provide better visualization of each single image. The software was built based on a minimalist and a user-friendly interface concept that might help in the smooth transition. It also has an interface for inputting diagnoses from the professional being trained, providing a result feedback. This system has been already completed, but hasn't been applied to any professional training yet.

3D printing of intracranial aneurysm based on intracranial digital subtraction angiography and its clinical application.

PubMed

Wang, Jian-Li; Yuan, Zi-Gang; Qian, Guo-Liang; Bao, Wu-Qiao; Jin, Guo-Liang

2018-06-01

The study aimed to develop simulation models including intracranial aneurysmal and parent vessel geometries, as well as vascular branches, through 3D printing technology. The simulation models focused on the benefits of aneurysmal treatments and clinical education. This prospective study included 13 consecutive patients who suffered from intracranial aneurysms confirmed by digital subtraction angiography (DSA) in the Neurosurgery Department of Shaoxing People's Hospital. The original 3D-DSA image data were extracted through the picture archiving and communication system and imported into Mimics. After reconstructing and transforming to Binary STL format, the simulation models of the hollow vascular tree were printed using 3D devices. The intracranial aneurysm 3D printing simulation model was developed based on DSA to assist neurosurgeons in aneurysmal treatments and residency training. Seven neurosurgical residents and 15 standardization training residents received their simulation model training and gave high assessments for the educational course with the follow-up qualitative questionnaire. 3D printed simulation models based on DSA can perfectly reveal target aneurysms and help neurosurgeons select therapeutic strategies precisely. As an educational tool, the 3D aneurysm vascular simulation model is useful for training residents.

Validity evidence for procedural competency in virtual reality robotic simulation, establishing a credible pass/fail standard for the vaginal cuff closure procedure.

PubMed

Hovgaard, Lisette Hvid; Andersen, Steven Arild Wuyts; Konge, Lars; Dalsgaard, Torur; Larsen, Christian Rifbjerg

2018-03-30

The use of robotic surgery for minimally invasive procedures has increased considerably over the last decade. Robotic surgery has potential advantages compared to laparoscopic surgery but also requires new skills. Using virtual reality (VR) simulation to facilitate the acquisition of these new skills could potentially benefit training of robotic surgical skills and also be a crucial step in developing a robotic surgical training curriculum. The study's objective was to establish validity evidence for a simulation-based test for procedural competency for the vaginal cuff closure procedure that can be used in a future simulation-based, mastery learning training curriculum. Eleven novice gynaecological surgeons without prior robotic experience and 11 experienced gynaecological robotic surgeons (> 30 robotic procedures) were recruited. After familiarization with the VR simulator, participants completed the module 'Guided Vaginal Cuff Closure' six times. Validity evidence was investigated for 18 preselected simulator metrics. The internal consistency was assessed using Cronbach's alpha and a composite score was calculated based on metrics with significant discriminative ability between the two groups. Finally, a pass/fail standard was established using the contrasting groups' method. The experienced surgeons significantly outperformed the novice surgeons on 6 of the 18 metrics. The internal consistency was 0.58 (Cronbach's alpha). The experienced surgeons' mean composite score for all six repetitions were significantly better than the novice surgeons' (76.1 vs. 63.0, respectively, p < 0.001). A pass/fail standard of 75/100 was established. Four novice surgeons passed this standard (false positives) and three experienced surgeons failed (false negatives). Our study has gathered validity evidence for a simulation-based test for procedural robotic surgical competency in the vaginal cuff closure procedure and established a credible pass/fail standard for future proficiency-based training.

Training Tools for Nontechnical Skills for Surgeons-A Systematic Review.

PubMed

Wood, Thomas Charles; Raison, Nicholas; Haldar, Shreya; Brunckhorst, Oliver; McIlhenny, Craig; Dasgupta, Prokar; Ahmed, Kamran

Development of nontechnical skills for surgeons has been recognized as an important factor in surgical care. Training tools for this specific domain are being created and validated to maximize the surgeon's nontechnical ability. This systematic review aims to outline, address, and recommend these training tools. A full and comprehensive literature search, using a systematic format, was performed on ScienceDirect and PubMed, with data extraction occurring in line with specified inclusion criteria. Systematic review was performed fully at King's College London. A total of 84 heterogeneous articles were used in this review. Further, 23 training tools including scoring systems, training programs, and mixtures of the two for a range of specialities were identified in the literature. Most can be applied to surgery overall, although some tools target specific specialities (such as neurosurgery). Interrater reliability, construct, content, and face validation statuses were variable according to the specific tool in question. Study results pertaining to nontechnical skill training tools have thus far been universally positive, but further studies are required for those more recently developed and less extensively used tools. Recommendations can be made for individual training tools based on their level of validation and for their target audience. Based on the number of studies performed and their status of validity, NOTSS and Oxford NOTECHS II can be considered the gold standard for individual- and team-based nontechnical skills training, respectively, especially when used in conjunction with a training program. Copyright © 2017 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

Calibrating and training of neutron based NSA techniques with less SNM standards

DOE Office of Scientific and Technical Information (OSTI.GOV)

Geist, William H; Swinhoe, Martyn T; Bracken, David S

2010-01-01

Accessing special nuclear material (SNM) standards for the calibration of and training on nondestructive assay (NDA) instruments has become increasingly difficult in light of enhanced safeguards and security regulations. Limited or nonexistent access to SNM has affected neutron based NDA techniques more than gamma ray techniques because the effects of multiplication require a range of masses to accurately measure the detector response. Neutron based NDA techniques can also be greatly affected by the matrix and impurity characteristics of the item. The safeguards community has been developing techniques for calibrating instrumentation and training personnel with dwindling numbers of SNM standards. Montemore » Carlo methods have become increasingly important for design and calibration of instrumentation. Monte Carlo techniques have the ability to accurately predict the detector response for passive techniques. The Monte Carlo results are usually benchmarked to neutron source measurements such as californium. For active techniques, the modeling becomes more difficult because of the interaction of the interrogation source with the detector and nuclear material; and the results cannot be simply benchmarked with neutron sources. A Monte Carlo calculated calibration curve for a training course in Indonesia of material test reactor (MTR) fuel elements assayed with an active well coincidence counter (AWCC) will be presented as an example. Performing training activities with reduced amounts of nuclear material makes it difficult to demonstrate how the multiplication and matrix properties of the item affects the detector response and limits the knowledge that can be obtained with hands-on training. A neutron pulse simulator (NPS) has been developed that can produce a pulse stream representative of a real pulse stream output from a detector measuring SNM. The NPS has been used by the International Atomic Energy Agency (IAEA) for detector testing and training applications at the Agency due to the lack of appropriate SNM standards. This paper will address the effect of reduced access to SNM for calibration and training of neutron NDA applications along with the advantages and disadvantages of some solutions that do not use standards, such as the Monte Carlo techniques and the NPS.« less

Promoting good health research practice in low- and middle-income countries

PubMed Central

Mahendradhata, Yodi; Nabieva, Jamila; Ahmad, Riris Andono; Henley, Patricia; Launois, Pascal; Merle, Corinne; Maure, Christine; Horstick, Olaf; Elango, Varalakshmi

2016-01-01

Background Good clinical practice (GCP) guidelines have been the source of improvement in the quality of clinical trials; however, there are limitations to the application of GCP in the conduct of health research beyond industry-sponsored clinical trials. The UNICEF/UNDP/World Bank/WHO Special Program for Research and Training in Tropical Disease is promoting good practice in all health research involving human through the Good Health Research Practice (GHRP) training program initiative. Objective To report the results of piloting the GHRP training program and formulate further steps to harness GHRP for promoting good practices in all health research involving human, particularly in low- and middle-income countries (LMICs). Design The objective of this training is to impart knowledge and skills for the application of ethical and quality principles to the design, conduct, recording, and reporting of health research involving human participants based on the level of risk, to ensure a fit-for-purpose quality system. This has been formulated into five sequential modules to be delivered in a 4-day course. Four courses have been organized in the pilot phase (2014–2015). The courses have been evaluated and assessed based on course feedback (quantitative and qualitative data) collected during course implementation and qualitative email-based pre- and post-course evaluation. Results Participants were highly satisfied with the course content and its organization. The relevance and applicability of the course content resulted in positive feedback and an articulated willingness to adapt and disseminate the course. Action points to strengthen the training program have been identified, and showed the imminent need to develop a consensus with a broader range of key stakeholders on the final set of GHRP standards and means for implementation. Conclusions There is an urgent need to harness the momentum to promote high-quality and ethical health research in LMICs through scaling up GHRP training and further development of GHRP principles into international standards. PMID:27498965

A 5 year longitudinal study of water quality for final rinsing in the single chamber washer-disinfector with a reverse osmosis plant.

PubMed

Uetera, Yushi; Kishii, Kozue; Yasuhara, Hiroshi; Kumada, Naohito; Moriya, Kyoji; Saito, Ryoichi; Okazaki, Mitsuhiro; Misawa, Yoshiki; Kawamura, Kunio

2013-01-01

This report deals with the construction and management of the reverse osmosis (RO) water system for final rinsing of surgical instruments in the washer-disinfector. Numerous operational challenges were encountered in our RO water system and these were analyzed utilizing the Ishikawa Fishbone diagram. The aim was to find potential problems and promote preventive system management for RO water. It was found that the measures that existed were inappropriate for preventing contamination in the heat-labile RO water system. The storage tank was found to be significantly contaminated and had to be replaced with a new one equipped with a sampling port and water drainage system. Additional filters and an UV treatment lamp were installed. The whole system disinfection started 1.5 years later using a peracetic acid-based compound after confirming the material compatibility. Operator errors were found when a new water engineer took over the duty from his predecessor. It was also found that there were some deficiencies in the standard operating procedures (SOPs), and that on-the-job training was not enough. The water engineer failed to disinfect the sampling port and water drainage system. The RO membrane had been used for 4 years, even though the SOP standard specified changing it as every 3 years. Various bacteria, such as Rothia mucilaginosa, were cultured from the RO water sampled from the equipment. Because Rothia mucilaginosa is a resident in the oral cavity and upper respiratory tract, it is believed that the bacteria were introduced into the system by the maintenance personnel or working environment. Therefore, the presence of R. mucilaginosa implied the failure of sanitary maintenance procedures. This study suggests that water systems should be designed based on the plans for profound system maintenance. It also suggests that SOP and on-the job training are essential to avoid any operator errors. These results must be carefully considered when either constructing new RO systems or performing maintenance and periodical examination of the equipment. Reverse osmosis (RO) water is used for final rinsing in our washer-disinfector. The authors used the Ishikawa Fishbone diagram to clarify the critical points for optimizing RO water quality. There existed no measures to prevent contamination in the heat-labile RO water system. The storage tank was significantly contaminated and had to be replaced with a new one equipped with a sampling port and water drainage system. Additional filters and an UV treatment lamp were installed. The whole system disinfection started 1.5 years later using a peracetic acid-based compound after confirming the material compatibility. Operator errors occurred when a new water engineer took over the duty from his predecessor. There were neither standard operating procedures (SOPs) nor on-the-job training. The new water engineer had failed to disinfect the sampling port and water drainage system. Rothia mucilaginosa was cultured from the RO water. It is a resident in the oral cavity and upper respiratory tract. This implied the possible failure of sanitary procedures in the system maintenance. The Ishikawa Fishbone diagram was useful for this study. It suggests that water systems should be designed with plans for system maintenance taken into account. It also suggests that SOP and on-the job training are essential in order to avoid operator errors.

Grantee :: NOAA Acquisition and Grants Office

Science.gov Websites

Guide AGO Systems C.Suite C.Request C.Award FPDS-NG SAM FAAPS CPARS eSRS Training COR Procurement Policy Training Forms External Links Grantee Policy DOC Grants and Cooperative Agreements Regulations Grants Online Grants Online Training Automated Standard Application for Payment (ASAP) - Grantee

78 FR 14875 - Petition for Waiver of Compliance

Federal Register 2010, 2011, 2012, 2013, 2014

2013-03-07

... certain provisions of the Federal railroad safety regulations contained at 49 CFR part 232--Brake System Safety Standards for Freight and Other Non-Passenger Trains and Equipment, End-of-Train Devices. FRA... 232.207(a) for certain Bakken-oil unit trains that originate at refineries in North Dakota. These...

78 FR 3965 - Petition for Waiver of Compliance

Federal Register 2010, 2011, 2012, 2013, 2014

2013-01-17

... provisions of the Federal railroad safety regulations contained at 49 CFR Part 232--Brake System Safety Standards for Freight and Other Non-Passenger Trains and Equipment; End-of-Train Devices. FRA assigned the... provisions of 49 CFR Part 232, specifically, Section 232.409(d)-- Inspection and testing of end-of-train...

78 FR 25346 - Petition for Waiver of Compliance

Federal Register 2010, 2011, 2012, 2013, 2014

2013-04-30

... from certain provisions of the Federal railroad safety regulations contained at 49 CFR Part 232, Brake System Safety Standards for Freight and Other Non-Passenger Trains and Equipment; End-of-Train Devices... five cycle trains and requests to extend the required mileage interval of the Class 1A brake tests of...

49 CFR 236.501 - Forestalling device and speed control.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 49 Transportation 4 2010-10-01 2010-10-01 false Forestalling device and speed control. 236.501... Train Stop, Train Control and Cab Signal Systems Standards § 236.501 Forestalling device and speed... the following features: (1) Low-speed restriction, requiring the train to proceed under slow speed...

49 CFR 236.501 - Forestalling device and speed control.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 49 Transportation 4 2011-10-01 2011-10-01 false Forestalling device and speed control. 236.501... Train Stop, Train Control and Cab Signal Systems Standards § 236.501 Forestalling device and speed... the following features: (1) Low-speed restriction, requiring the train to proceed under slow speed...

Why standard brain-computer interface (BCI) training protocols should be changed: an experimental study

NASA Astrophysics Data System (ADS)

Jeunet, Camille; Jahanpour, Emilie; Lotte, Fabien

2016-06-01

Objective. While promising, electroencephaloraphy based brain-computer interfaces (BCIs) are barely used due to their lack of reliability: 15% to 30% of users are unable to control a BCI. Standard training protocols may be partly responsible as they do not satisfy recommendations from psychology. Our main objective was to determine in practice to what extent standard training protocols impact users’ motor imagery based BCI (MI-BCI) control performance. Approach. We performed two experiments. The first consisted in evaluating the efficiency of a standard BCI training protocol for the acquisition of non-BCI related skills in a BCI-free context, which enabled us to rule out the possible impact of BCIs on the training outcome. Thus, participants (N = 54) were asked to perform simple motor tasks. The second experiment was aimed at measuring the correlations between motor tasks and MI-BCI performance. The ten best and ten worst performers of the first study were recruited for an MI-BCI experiment during which they had to learn to perform two MI tasks. We also assessed users’ spatial ability and pre-training μ rhythm amplitude, as both have been related to MI-BCI performance in the literature. Main results. Around 17% of the participants were unable to learn to perform the motor tasks, which is close to the BCI illiteracy rate. This suggests that standard training protocols are suboptimal for skill teaching. No correlation was found between motor tasks and MI-BCI performance. However, spatial ability played an important role in MI-BCI performance. In addition, once the spatial ability covariable had been controlled for, using an ANCOVA, it appeared that participants who faced difficulty during the first experiment improved during the second while the others did not. Significance. These studies suggest that (1) standard MI-BCI training protocols are suboptimal for skill teaching, (2) spatial ability is confirmed as impacting on MI-BCI performance, and (3) when faced with difficult pre-training, subjects seemed to explore more strategies and therefore learn better.

Increasing HACCP awareness: a training intervention for caterers.

PubMed

Worsfold, Denise; Worsfold, Philip

2005-05-01

The European Union Food Hygiene Regulations, which will apply to member states from 2005/06, will replace the existing body of food hygiene legislation with more modern, risk-based requirements. Food businesses (except those in primary production) will be required to put in place food safety management procedures based on Hazard Analysis Critical Control Point (HACCP) principles. In the UK, the Food Standards Agency (FSA) has set itself the target of reducing foodborne disease by 20% by 2006. It plans to do this by improving food safety through the food chain and has formulated an action plan for the catering industry which includes training, provision of guidance materials, business support and monitoring. In Wales, the FSA and the Welsh Development Agency have jointly funded local authorities to raise the HACCP awareness of caterers. This paper reviews the approach used to raise HACCP awareness by the Local Authorities South East Wales Food Group. The Group commissioned the design, delivery and evaluation of a Hygiene and HACCP training course for caterers. Questionnaires were used to evaluate caterers' knowledge and perceptions of, and attitudes towards, hygiene and HACCP before, during and after training. A final questionnaire was mailed out to participants several months after the training course had finished. The results show that prior to training, the understanding of HACCP, hazards, risk and risk management was low. The results also show that caterers were not hostile to this system of food hygiene management. Following training, participants showed a greater awareness of HACCP but their perceptions of risk were still low. Some participants claimed to have implemented the HACCP system in their business following training. Many caterers believed that additional assistancewould be required to help them proceed with HACCP implementation.

Photoelectric professional students in common universities cultivate way to explore under the background of professional certification

NASA Astrophysics Data System (ADS)

Sun, Yan-jun; Wang, Li; Leng, Yan-bing

2017-08-01

In view of the engineering education professional certification of specialty construction and the specific requirements of the training system, combining with our school optoelectronic information science and engineering characteristics, analysis of the optoelectronic information science and engineering in our school problems and challenges, to locate the specific professional training objectives. From the service oriented industry demand for talent ability, at the same time, according to the ministry of education professional norms of the development of the photoelectric teaching steering committee, and the professional development and the characteristics of target, to build a set to conform to the goal of cultivating the professional curriculum system. At the same time set up a from fundamental to professional practice teaching system, covers the course experiment, course design, case teaching, comprehensive training, such as graduation design practice. Which implements a whole ability training from the practice of foundation to high-end chain, embodies the training goal emphasize "outstanding practical skills, quality education is distinct culture characteristic. By further speed up the professional construction, professional certification standards to standardize our training process, improved the level of professional training, and improve the comprehensive quality of the graduates and talent of social competitiveness, fostered more professional talents for the country.

Stress Inoculation through Cognitive and Biofeedback Training

DTIC Science & Technology

2010-12-01

based on Heart Rate Variability ( HRV ) with innovative simulation game-based training tools. The training system described here will be implemented on a...Variability ( HRV ) with innovative simulation game-based training tools. The training system described here will be implemented on a mobile device...and studies (e.g. Fletcher & Tobias, 2006; Thayer, 2009). HRV Coherence Training for Stress Resilience Satisfactory performance in stressful

2nd Annual Invited Experts Meeting on Simulation-Based Medical Training

DTIC Science & Technology

2005-12-01

medicine, government, and regulatory officials with medical simulation and patient safety experts. In 2005, TATRC continued its support of this effort...standardized patients allow students to interact with “actors” specifically trained to present their medical histories, simulate physical symptoms, and...simulation-based medical training benefits all of us, as follows: • Patients benefit from improved health outcomes and reduced errors and deaths

An FPGA-Based Rapid Wheezing Detection System

PubMed Central

Lin, Bor-Shing; Yen, Tian-Shiue

2014-01-01

Wheezing is often treated as a crucial indicator in the diagnosis of obstructive pulmonary diseases. A rapid wheezing detection system may help physicians to monitor patients over the long-term. In this study, a portable wheezing detection system based on a field-programmable gate array (FPGA) is proposed. This system accelerates wheezing detection, and can be used as either a single-process system, or as an integrated part of another biomedical signal detection system. The system segments sound signals into 2-second units. A short-time Fourier transform was used to determine the relationship between the time and frequency components of wheezing sound data. A spectrogram was processed using 2D bilateral filtering, edge detection, multithreshold image segmentation, morphological image processing, and image labeling, to extract wheezing features according to computerized respiratory sound analysis (CORSA) standards. These features were then used to train the support vector machine (SVM) and build the classification models. The trained model was used to analyze sound data to detect wheezing. The system runs on a Xilinx Virtex-6 FPGA ML605 platform. The experimental results revealed that the system offered excellent wheezing recognition performance (0.912). The detection process can be used with a clock frequency of 51.97 MHz, and is able to perform rapid wheezing classification. PMID:24481034

Modular Training Systems and Strategies: An International Meeting (Washington, D.C., May 11-12, 1992).

ERIC Educational Resources Information Center

American Society for Training and Development, Alexandria, VA.

This publication contains materials from a conference to discuss modular approaches to curriculum design. The materials from the United States and five other countries address both national skills standards and modular systems of training delivery. An introduction provides brief summaries of the conference materials and the agenda. "National…

Users' evaluation of the Navy Computer-Assisted Medical Diagnosis System.

PubMed

Merrill, L L; Pearsall, D M; Gauker, E D

1996-01-01

U.S. Navy Independent Duty Corpsmen (IDCs) aboard small ships and submarines are responsible for all clinical and related health care duties while at sea. During deployment, life-threatening illnesses sometimes require evacuation to a shore-based treatment facility. At-sea evacuations are dangerous, expensive, and may compromise the mission of the vessel. Therefore, Group Medical Officers and IDCs were trained to use the Navy Computer-Assisted Medical Diagnosis (NCAMD) system during deployment. They were then surveyed to evaluate the NCAMD system. Their responses show that NCAMD is a cost-efficient, user-friendly package. It is easy to learn, and is especially valuable for training in the diagnosis of chest and abdominal complaints. However, the delivery of patient care at sea would significantly improve if computer hardware were upgraded to current industry standards. Also, adding various computer peripheral devices, structured forms, and reference materials to the at-sea clinician's resources could enhance shipboard patient care.

Competency-based medical education and continuing professional development: A conceptualization for change.

PubMed

Lockyer, Jocelyn; Bursey, Ford; Richardson, Denyse; Frank, Jason R; Snell, Linda; Campbell, Craig

2017-06-01

Competency-based medical education (CBME) is as important in continuing professional development (CPD) as at any other stage of a physician's career. Principles of CBME have the potential to revolutionize CPD. Transitioning to CBME-based CPD will require a cultural change to gain commitment from physicians, their employers and institutions, CPD providers, professional organizations, and medical regulators. It will require learning to be aligned with professional and workplace standards. Practitioners will need to develop the expertise to systematically examine their own clinical performance data, identify performance improvement opportunities and possibilities, and develop a plan to address areas of concern. Health care facilities and systems will need to produce data on a regular basis and to develop and train CPD educators who can work with physician groups. Stakeholders, such as medical regulatory authorities who are responsible for licensing physicians and other standard-setting bodies that credential and develop maintenance-of-certification systems, will need to change their paradigm of competency enhancement through CPD.

Wall-based measurement features provides an improved IVUS coronary artery risk assessment when fused with plaque texture-based features during machine learning paradigm.

PubMed

Banchhor, Sumit K; Londhe, Narendra D; Araki, Tadashi; Saba, Luca; Radeva, Petia; Laird, John R; Suri, Jasjit S

2017-12-01

Planning of percutaneous interventional procedures involves a pre-screening and risk stratification of the coronary artery disease. Current screening tools use stand-alone plaque texture-based features and therefore lack the ability to stratify the risk. This IRB approved study presents a novel strategy for coronary artery disease risk stratification using an amalgamation of IVUS plaque texture-based and wall-based measurement features. Due to common genetic plaque makeup, carotid plaque burden was chosen as a gold standard for risk labels during training-phase of machine learning (ML) paradigm. Cross-validation protocol was adopted to compute the accuracy of the ML framework. A set of 59 plaque texture-based features was padded with six wall-based measurement features to show the improvement in stratification accuracy. The ML system was executed using principle component analysis-based framework for dimensionality reduction and uses support vector machine classifier for training and testing-phases. The ML system produced a stratification accuracy of 91.28%, demonstrating an improvement of 5.69% when wall-based measurement features were combined with plaque texture-based features. The fused system showed an improvement in mean sensitivity, specificity, positive predictive value, and area under the curve by: 6.39%, 4.59%, 3.31% and 5.48%, respectively when compared to the stand-alone system. While meeting the stability criteria of 5%, the ML system also showed a high average feature retaining power and mean reliability of 89.32% and 98.24%, respectively. The ML system showed an improvement in risk stratification accuracy when the wall-based measurement features were fused with the plaque texture-based features. Copyright © 2017 Elsevier Ltd. All rights reserved.

Creating objective and measurable postgraduate year 1 residency graduation requirements.

PubMed

Starosta, Kaitlin; Davis, Susan L; Kenney, Rachel M; Peters, Michael; To, Long; Kalus, James S

2017-03-15

The process of developing objective and measurable postgraduate year 1 (PGY1) residency graduation requirements and a progress tracking system is described. The PGY1 residency accreditation standard requires that programs establish criteria that must be met by residents for successful completion of the program (i.e., graduation requirements), which should presumably be aligned with helping residents to achieve the purpose of residency training. In addition, programs must track a resident's progress toward fulfillment of residency goals and objectives. Defining graduation requirements and establishing the process for tracking residents' progress are left up to the discretion of the residency program. To help standardize resident performance assessments, leaders of an academic medical center-based PGY1 residency program developed graduation requirement criteria that are objective, measurable, and linked back to residency goals and objectives. A system for tracking resident progress relative to quarterly progress targets was instituted. Leaders also developed a focused, on-the-spot skills assessment termed "the Thunderdome," which was designed for objective evaluation of direct patient care skills. Quarterly data on residents' progress are used to update and customize each resident's training plan. Implementation of this system allowed seamless linkage of the training plan, the progress tracking system, and the specified graduation requirement criteria. PGY1 residency requirements that are objective, that are measurable, and that attempt to identify what skills the resident must demonstrate in order to graduate from the program were developed for use in our residency program. A system for tracking the residents' progress by comparing residents' performance to predetermined quarterly benchmarks was developed. Copyright © 2017 by the American Society of Health-System Pharmacists, Inc. All rights reserved.

Meeting Skills Needs in a Market-Based Training System: A Study of Employer Perceptions and Responses to Training Challenges in the Australian Transport and Logistics Industry

ERIC Educational Resources Information Center

Gekara, Victor O.; Snell, Darryn; Chhetri, Prem; Manzoni, Alex

2014-01-01

Many countries are adopting market-based training systems to address industry skills needs. This paper examines the marketisation of Australia's training system and the implications for training provision and outcomes in the Transport and Logistics industry. Drawing on qualitative interviews from industry employers and training providers, we…

Interleaved Training and Training-Based Transmission Design for Hybrid Massive Antenna Downlink

NASA Astrophysics Data System (ADS)

Zhang, Cheng; Jing, Yindi; Huang, Yongming; Yang, Luxi

2018-06-01

In this paper, we study the beam-based training design jointly with the transmission design for hybrid massive antenna single-user (SU) and multiple-user (MU) systems where outage probability is adopted as the performance measure. For SU systems, we propose an interleaved training design to concatenate the feedback and training procedures, thus making the training length adaptive to the channel realization. Exact analytical expressions are derived for the average training length and the outage probability of the proposed interleaved training. For MU systems, we propose a joint design for the beam-based interleaved training, beam assignment, and MU data transmissions. Two solutions for the beam assignment are provided with different complexity-performance tradeoff. Analytical results and simulations show that for both SU and MU systems, the proposed joint training and transmission designs achieve the same outage performance as the traditional full-training scheme but with significant saving in the training overhead.

Skill Standards. Experience in Certification Systems Shows Industry Involvement To Be Key. Report to the Chairman, Joint Economic Committee, U.S. Congress.

ERIC Educational Resources Information Center

General Accounting Office, Washington, DC. Div. of Human Resources.

In an attempt to determine their role in improving the efficiency and effectiveness of skill training programs, existing standards and certification systems in 20 selected occupations were reviewed to identify the following: their common characteristics, barriers to their development and use, benefits of standards and certification to employers…

Standardized patient walkthroughs in the National Drug Abuse Treatment Clinical Trials Network: common challenges to protocol implementation.

PubMed

Fussell, Holly E; Kunkel, Lynn E; McCarty, Dennis; Lewy, Colleen S

2011-09-01

Training research staff to implement clinical trials occurring in community-based addiction treatment programs presents unique challenges. Standardized patient walkthroughs of study procedures may enhance training and protocol implementation. Examine and discuss cross-site and cross-study challenges of participant screening and data collection procedures identified during standardized patient walkthroughs of multi-site clinical trials. Actors portrayed clients and "walked through" study procedures with protocol research staff. The study completed 57 walkthroughs during implementation of 4 clinical trials. Observers and walkthrough participants identified three areas of concern (consent procedures, screening and assessment processes, and protocol implementation) and made suggestions for resolving the concerns. Standardized patient walkthroughs capture issues with study procedures previously unidentified with didactic training or unscripted rehearsals. Clinical trials within the National Drug Abuse Treatment Clinical Trials Network are conducted in addiction treatment centers that vary on multiple dimensions. Based on walkthrough observations, the national protocol team and local site leadership modify standardized operating procedures and resolve cross-site problems prior to recruiting study participants. The standardized patient walkthrough improves consistency across study sites and reduces potential site variation in study outcomes.

The Impact of the Developmental Training Model on Staff Development in Air Force Child Development Programs

ERIC Educational Resources Information Center

Bird, Candace Maria Edmonds

2010-01-01

In an effort to standardize training delivery and to individualize staff development based on observation and reflective practice, the Air Force implemented the Developmental Training Model (DTM) in its Child Development Programs. The goal of the Developmental Training Model is to enhance high quality programs through improvements in the training…

Exploring Teacher Candidates' Attitudes towards Pedagogical Teacher Training Based on Different Variables

ERIC Educational Resources Information Center

Toraman, Cetin; Aydin, Hasan; Ulubey, Ozgur

2016-01-01

The raising of the life standards of individuals living within a society is only possible through the provision of quality education. Quality education can be realized only through the training of teachers with the necessary skills and positive attitudes towards the training provided at faculties of education and through teacher training programs.…

20 CFR 670.505 - What types of training must Job Corps centers provide?

Code of Federal Regulations, 2011 CFR

2011-04-01

... provide basic education, vocational and social skills training. The Secretary provides curriculum standards and guidelines. (b) Each center must provide students with competency-based or individualized...

Current Status and Future Prospects of Clinical Psycholog

PubMed Central

Baker, Timothy B.; McFall, Richard M.; Shoham, Varda

2010-01-01

SUMMARY The escalating costs of health care and other recent trends have made health care decisions of great societal import, with decision-making responsibility often being transferred from practitioners to health economists, health plans, and insurers. Health care decision making increasingly is guided by evidence that a treatment is efficacious, effective–disseminable, cost-effective, and scientifically plausible. Under these conditions of heightened cost concerns and institutional–economic decision making, psychologists are losing the opportunity to play a leadership role in mental and behavioral health care: Other types of practitioners are providing an increasing proportion of delivered treatment, and the use of psychiatric medication has increased dramatically relative to the provision of psychological interventions. Research has shown that numerous psychological interventions are efficacious, effective, and cost-effective. However, these interventions are used infrequently with patients who would benefit from them, in part because clinical psychologists have not made a convincing case for the use of these interventions (e.g., by supplying the data that decision makers need to support implementation of such interventions) and because clinical psychologists do not themselves use these interventions even when given the opportunity to do so. Clinical psychologists’ failure to achieve a more significant impact on clinical and public health may be traced to their deep ambivalence about the role of science and their lack of adequate science training, which leads them to value personal clinical experience over research evidence, use assessment practices that have dubious psychometric support, and not use the interventions for which there is the strongest evidence of efficacy. Clinical psychology resembles medicine at a point in its history when practitioners were operating in a largely prescientific manner. Prior to the scientific reform of medicine in the early 1900s, physicians typically shared the attitudes of many of today’s clinical psychologists, such as valuing personal experience over scientific research. Medicine was reformed, in large part, by a principled effort by the American Medical Association to increase the science base of medical school education. Substantial evidence shows that many clinical psychology doctoral training programs, especially PsyD and for-profit programs, do not uphold high standards for graduate admission, have high student–faculty ratios, deemphasize science in their training, and produce students who fail to apply or generate scientific knowledge. A promising strategy for improving the quality and clinical and public health impact of clinical psychology is through a new accreditation system that demands highquality science training as a central feature of doctoral training in clinical psychology. Just as strengthening training standards in medicine markedly enhanced the quality of health care, improved training standards in clinical psychology will enhance health and mental health care. Such a system will (a) allow the public and employers to identify scientifically trained psychologists; (b) stigmatize ascientific training programs and practitioners; (c) produce aspirational effects, thereby enhancing training quality generally; and (d) help accredited programs improve their training in the application and generation of science. These effects should enhance the generation, application, and dissemination of experimentally supported interventions, thereby improving clinical and public health. Experimentally based treatments not only are highly effective but also are cost-effective relative to other interventions; therefore, they could help control spiraling health care costs. The new Psychological Clinical Science Accreditation System (PCSAS) is intended to accredit clinical psychology training programs that offer highquality science-centered education and training, producing graduates who are successful in generating and applying scientific knowledge. Psychologists, universities, and other stakeholders should vigorously support this new accreditation system as the surest route to a scientifically principled clinical psychology that can powerfully benefit clinical and public health. PMID:20865146

An analysis of the influence of deep neural network (DNN) topology in bottleneck feature based language recognition.

PubMed

Lozano-Diez, Alicia; Zazo, Ruben; Toledano, Doroteo T; Gonzalez-Rodriguez, Joaquin

2017-01-01

Language recognition systems based on bottleneck features have recently become the state-of-the-art in this research field, showing its success in the last Language Recognition Evaluation (LRE 2015) organized by NIST (U.S. National Institute of Standards and Technology). This type of system is based on a deep neural network (DNN) trained to discriminate between phonetic units, i.e. trained for the task of automatic speech recognition (ASR). This DNN aims to compress information in one of its layers, known as bottleneck (BN) layer, which is used to obtain a new frame representation of the audio signal. This representation has been proven to be useful for the task of language identification (LID). Thus, bottleneck features are used as input to the language recognition system, instead of a classical parameterization of the signal based on cepstral feature vectors such as MFCCs (Mel Frequency Cepstral Coefficients). Despite the success of this approach in language recognition, there is a lack of studies analyzing in a systematic way how the topology of the DNN influences the performance of bottleneck feature-based language recognition systems. In this work, we try to fill-in this gap, analyzing language recognition results with different topologies for the DNN used to extract the bottleneck features, comparing them and against a reference system based on a more classical cepstral representation of the input signal with a total variability model. This way, we obtain useful knowledge about how the DNN configuration influences bottleneck feature-based language recognition systems performance.

OPALS: A COTS-based Tech Demo of Optical Communications

NASA Technical Reports Server (NTRS)

Oaida, Bogdan

2012-01-01

I. Objective: Deliver video from ISS to optical ground terminal via an optical communications link. a) JPL Phaeton/Early Career Hire (ECH) training project. b) Implemented as Class-D payload. c) Downlink at approx.30Mb/s. II. Flight System a) Optical Head Beacon Acquisition Camera. Downlink Transmitter. 2-axis Gimbal. b) Sealed Container Laser Avionics Power distribution Digital I/O board III. Implementation: a) Ground Station - Optical Communications Telescope Laboratory at Table Mountain Facility b) Flight System mounted to ISS FRAM as standard I/F. Attached externally on Express Logistics Carrier.

Streaming Media for Web Based Training.

ERIC Educational Resources Information Center

Childers, Chad; Rizzo, Frank; Bangert, Linda

This paper discusses streaming media for World Wide Web-based training (WBT). The first section addresses WBT in the 21st century, including the Synchronized Multimedia Integration Language (SMIL) standard that allows multimedia content such as text, pictures, sound, and video to be synchronized for a coherent learning experience. The second…

A statewide nurse training program for a hospital based infant abusive head trauma prevention program.

PubMed

Nocera, Maryalice; Shanahan, Meghan; Murphy, Robert A; Sullivan, Kelly M; Barr, Marilyn; Price, Julie; Zolotor, Adam

2016-01-01

Successful implementation of universal patient education programs requires training large numbers of nursing staff in new content and procedures and maintaining fidelity to program standards. In preparation for statewide adoption of a hospital based universal education program, nursing staff at 85 hospitals and 1 birthing center in North Carolina received standardized training. This article describes the training program and reports findings from the process, outcome and impact evaluations of this training. Evaluation strategies were designed to query nurse satisfaction with training and course content; determine if training conveyed new information, and assess if nurses applied lessons from the training sessions to deliver the program as designed. Trainings were conducted during April 2008-February 2010. Evaluations were received from 4358 attendees. Information was obtained about training type, participants' perceptions of newness and usefulness of information and how the program compared to other education materials. Program fidelity data were collected using telephone surveys about compliance to delivery of teaching points and teaching behaviors. Results demonstrate high levels of satisfaction and perceptions of program utility as well as adherence to program model. These findings support the feasibility of implementing a universal patient education programs with strong uptake utilizing large scale systematic training programs. Copyright © 2015 Elsevier Ltd. All rights reserved.

Computer-based attention training in the schools for children with attention deficit/hyperactivity disorder: a preliminary trial.

PubMed

Steiner, Naomi J; Sheldrick, Radley Christopher; Gotthelf, David; Perrin, Ellen C

2011-07-01

Objective. This study examined the efficacy of 2 computer-based training systems to teach children with attention deficit/hyperactivity disorder (ADHD) to attend more effectively. Design/methods. A total of 41 children with ADHD from 2 middle schools were randomly assigned to receive 2 sessions a week at school of either neurofeedback (NF) or attention training through a standard computer format (SCF), either immediately or after a 6-month wait (waitlist control group). Parents, children, and teachers completed questionnaires pre- and postintervention. Results. Primary parents in the NF condition reported significant (P < .05) change on Conners's Rating Scales-Revised (CRS-R) and Behavior Assessment Scales for Children (BASC) subscales; and in the SCF condition, they reported significant (P < .05) change on the CRS-R Inattention scale and ADHD index, the BASC Attention Problems Scale, and on the Behavioral Rating Inventory of Executive Functioning (BRIEF). Conclusion. This randomized control trial provides preliminary evidence of the effectiveness of computer-based interventions for ADHD and supports the feasibility of offering them in a school setting.

Enhancement of Fast Face Detection Algorithm Based on a Cascade of Decision Trees

NASA Astrophysics Data System (ADS)

Khryashchev, V. V.; Lebedev, A. A.; Priorov, A. L.

2017-05-01

Face detection algorithm based on a cascade of ensembles of decision trees (CEDT) is presented. The new approach allows detecting faces other than the front position through the use of multiple classifiers. Each classifier is trained for a specific range of angles of the rotation head. The results showed a high rate of productivity for CEDT on images with standard size. The algorithm increases the area under the ROC-curve of 13% compared to a standard Viola-Jones face detection algorithm. Final realization of given algorithm consist of 5 different cascades for frontal/non-frontal faces. One more thing which we take from the simulation results is a low computational complexity of CEDT algorithm in comparison with standard Viola-Jones approach. This could prove important in the embedded system and mobile device industries because it can reduce the cost of hardware and make battery life longer.

[Urogynaecological training situation in Germany : Gap between demand and reality].

PubMed

Kranz, J; Schneidewind, L; Barski, D; Tahbaz, R; Huppertz, N; Zerrenner, C; Grabbert, M; Mühlstädt, S; Queissert, F; Schott, S; Grundl, S; Boymanns, A; Steffens, J; Pelzer, A E

2016-08-01

With increasing life expectancy, progressive demographic change and decreasing societal stigmatization of incontinence urologists and gynaecologists are increasingly faced with urogynaecological challenges. To date however, urogynaecology is a poorly standardized area of expertise in both disciplines. Therefore, the urogynaecology training, especially in Germany, is very heterogeneous and requires evaluation as well as improvement. The GeSRU-Academics research group "Functional urology and LUTS" evaluated this subject nationwide among urological and gynecological trainees and their chief physicians by using a comprehensive questionnaire (34/38 multiple-choice items) between April 2015 and May 2016. 336 urological residents and 190 chief physicians as well as 171 gynaecological residents and 175 chief physicians participated in the survey. Of all trainees, 70.0 % stated a personal interest in urogynaecology, but 45.4 % (gynaecological residents) and 52.9 % (urological residents) mention not to receive a standardized training in their own department. The chief physicians' survey resulted in discrepancies concerning the same question, <10 % of all residents do not receive a standardized urogynaecological training from their point of view. However, standardized urogynaecological training is of importance for those chief physicians. There is a discrepancy between expectations and reality of urogynaecological education and training. To enable a well-structured and standardized urogynaecological education and training, it is compulsory to focus on an interdisciplinary cooperation and to promote multidisciplinary development. A broad-based, well-designed training network and curricula should be established and used consistently.

Application of See One, Do One, Teach One Concept in Surgical Training

PubMed Central

Kotsis, Sandra V.; Chung, Kevin C.

2016-01-01

Background The traditional method of teaching in Surgery is known as “See One, Do One, Teach One.” However, many have argued that this method is no longer applicable mainly because of concerns for patient safety. The purpose of this paper is to show that the basis of the traditional teaching method is still valid in surgical training if it is combined with various adult learning principles. Methods We reviewed literature regarding the history of the formation of the surgical residency program, adult learning principles, mentoring, and medical simulation. We provide examples for how these learning techniques can be incorporated into a surgical resident training program. Results The surgical residency program created by Dr. William Halsted remained virtually unchanged until recently with reductions in resident work hours and changes to a competency-based training system. Such changes have reduced the teaching time between attending physicians and residents. Learning principles such as “Experience, Observation, Thinking and Action” as well as deliberate practice can be used to train residents. Mentoring is also an important aspect in teaching surgical technique. We review the different types of simulators: standardized patients, virtual reality applications, and high-fidelity mannequin simulators and the advantages and disadvantages of using them. Conclusions The traditional teaching method of “see one, do one, teach one” in surgical residency programs is simple but still applicable. It needs to evolve with current changes in the medical system to adequately train surgical residents and also provide patients with safe, evidence-based care. PMID:23629100

Validation of a scale for network therapy: a technique for systematic use of peer and family support in addition treatment.

PubMed

Keller, D S; Galanter, M; Weinberg, S

1997-02-01

Substance abuse treatments are increasingly employing standardized formats. This is especially the case for approaches that utilize an individual psychotherapy format but less so for family-based approaches. Network therapy, an approach that involves family members and peers in the patient's relapse prevention efforts, is theoretically and clinically differentiated in this paper from family systems therapy for addiction. Based on these conceptual differences, a Network Therapy Rating Scale (NTRS) was developed to measure the integrity and differentiability of network therapy from other family-based approaches to addiction treatment. Seven addictions faculty and 10 third- and fourth-year psychiatry residents recently trained in the network approach used the NTRS to rate excerpts of network and family systems therapy sessions. Data revealed the NTRS had high internal consistency reliability when utilized by both groups of raters. In addition, network and nonnetwork subscales within the NTRS rated congruent therapy excerpts significantly higher than noncongruent therapy excerpts, indicating that the NTRS subscales measure what they are designed to measure. Implications for research and training are discussed.

MASCARET: creating virtual learning environments from system modelling

NASA Astrophysics Data System (ADS)

Querrec, Ronan; Vallejo, Paola; Buche, Cédric

2013-03-01

The design process for a Virtual Learning Environment (VLE) such as that put forward in the SIFORAS project (SImulation FOR training and ASsistance) means that system specifications can be differentiated from pedagogical specifications. System specifications can also be obtained directly from the specialists' expertise; that is to say directly from Product Lifecycle Management (PLM) tools. To do this, the system model needs to be considered as a piece of VLE data. In this paper we present Mascaret, a meta-model which can be used to represent such system models. In order to ensure that the meta-model is capable of describing, representing and simulating such systems, MASCARET is based SysML1, a standard defined by Omg.

Deviation Management: Key Management Subsystem Driver of Knowledge-Based Continuous Improvement in the Henry Ford Production System.

PubMed

Zarbo, Richard J; Copeland, Jacqueline R; Varney, Ruan C

2017-10-01

To develop a business subsystem fulfilling International Organization for Standardization 15189 nonconformance management regulatory standard, facilitating employee engagement in problem identification and resolution to effect quality improvement and risk mitigation. From 2012 to 2016, the integrated laboratories of the Henry Ford Health System used a quality technical team to develop and improve a management subsystem designed to identify, track, trend, and summarize nonconformances based on frequency, risk, and root cause for elimination at the level of the work. Programmatic improvements and training resulted in markedly increased documentation culminating in 71,641 deviations in 2016 classified by a taxonomy of 281 defect types into preanalytic (74.8%), analytic (23.6%), and postanalytic (1.6%) testing phases. The top 10 deviations accounted for 55,843 (78%) of the total. Deviation management is a key subsystem of managers' standard work whereby knowledge of nonconformities assists in directing corrective actions and continuous improvements that promote consistent execution and higher levels of performance. © American Society for Clinical Pathology, 2017. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com

Army Contracting: Training and Guidance Needed to Ensure Appropriate Use of the Option to Extend Services Clause

DTIC Science & Technology

2016-01-28

reproduce this material separately. The Government Accountability Office, the audit , evaluation, and investigative arm of...Executive Director Army Contracting Command-Redstone Arsenal Army Contracting: Training and Guidance Needed to Ensure Appropriate Use of the Option to...which this report is based in accordance with generally accepted government auditing standards. Those standards require that we plan and perform the

High-resolution broadband terahertz spectroscopy via electronic heterodyne detection of photonically generated terahertz frequency comb.

PubMed

Pavelyev, D G; Skryl, A S; Bakunov, M I

2014-10-01

We report an alternative approach to the terahertz frequency-comb spectroscopy (TFCS) based on nonlinear mixing of a photonically generated terahertz pulse train with a continuous wave signal from an electronic synthesizer. A superlattice is used as a nonlinear mixer. Unlike the standard TFCS technique, this approach does not require a complex double-laser system but retains the advantages of TFCS-high spectral resolution and wide bandwidth.

Paramedic specialization: a strategy for better out-of-hospital care.

PubMed

Caffrey, Sean M; Clark, John R; Bourn, Scott; Cole, Jim; Cole, John S; Mandt, Maria; Murray, Jimm; Sibold, Harry; Stuhlmiller, David; Swanson, Eric R

2014-01-01

Demographic, economic, and political forces are driving significant change in the US health care system. Paramedics are a health profession currently providing advanced emergency care and medical transportation throughout the United States. As the health care system demands more team-based care in nonacute, community, interfacility, and tactical response settings, specialized paramedic practitioners could be a valuable and well-positioned resource to meet these needs. Currently, there is limited support for specialty certifications that demand appropriate education, training, or experience standards before specialized practice by paramedics. A fragmented approach to specialty paramedic practice currently exists across our country in which states, regulators, nonprofit organizations, and other health care professions influence and regulate the practice of paramedicine. Multiple other medical professions, however, have already developed effective systems over the last century that can be easily adapted to the practice of paramedicine. Paramedicine practitioners need to organize a profession-based specialty board to organize and standardize a specialty certification system that can be used on a national level. Copyright © 2014 Air Medical Journal Associates. Published by Elsevier Inc. All rights reserved.

Point-of-care ultrasound education: the increasing role of simulation and multimedia resources.

PubMed

Lewiss, Resa E; Hoffmann, Beatrice; Beaulieu, Yanick; Phelan, Mary Beth

2014-01-01

This article reviews the current technology, literature, teaching models, and methods associated with simulation-based point-of-care ultrasound training. Patient simulation appears particularly well suited for learning point-of-care ultrasound, which is a required core competency for emergency medicine and other specialties. Work hour limitations have reduced the opportunities for clinical practice, and simulation enables practicing a skill multiple times before it may be used on patients. Ultrasound simulators can be categorized into 2 groups: low and high fidelity. Low-fidelity simulators are usually static simulators, meaning that they have nonchanging anatomic examples for sonographic practice. Advantages are that the model may be reused over time, and some simulators can be homemade. High-fidelity simulators are usually high-tech and frequently consist of many computer-generated cases of virtual sonographic anatomy that can be scanned with a mock probe. This type of equipment is produced commercially and is more expensive. High-fidelity simulators provide students with an active and safe learning environment and make a reproducible standardized assessment of many different ultrasound cases possible. The advantages and disadvantages of using low- versus high-fidelity simulators are reviewed. An additional concept used in simulation-based ultrasound training is blended learning. Blended learning may include face-to-face or online learning often in combination with a learning management system. Increasingly, with simulation and Web-based learning technologies, tools are now available to medical educators for the standardization of both ultrasound skills training and competency assessment.

Take-Home Training in Laparoscopy.

PubMed

Thinggaard, Ebbe

2017-04-01

When laparoscopy was first introduced, skills were primarily taught using the apprenticeship model. A limitation of this method when compared to open surgery, was that it requires more time to practise and more frequent learning opportunities in clinical practice. The unique set of skills required in laparoscopy highlighted the need for new training methods that reduce the need for supervision and do not put the patient at risk. Simulation training was developed to meet this need. The overall purpose of this thesis was to explore simulation-based laparoscopic training at home. The thesis consists of five papers: a review, a validation study, a study of methodology, a randomised controlled trial and a mixed-methods study. Our aims were to review the current knowledge on training off-site, to develop and explore validity for a training and assessment system, to investigate the effect of take-home training in a simulation-based laparoscopic training programme, and to explore the use of take-home training. The first paper in this thesis is a scoping review. The aim of the review was to explore the current knowledge on off-site laparoscopic skills training. We found that off-site training was feasible but that changes were required in order for it to become an effective method of training. Furthermore, the select-ed instructional design varied and training programmes were designed using a variety of educational theories. Based on our findings, we recommended that courses and training curricula should follow established education theories such as proficiency-based learning and deliberate practice. Principles of directed self-regulated learning could be used to improve off-site laparoscopic training programmes. In the second study, we set out to develop and explore validity evidence of the TABLT test. The TABLT test was developed for basic laparoscopic skills training in a cross-specialty curriculum. We found validity evidence to support the TABLT test as a summative test in a basic laparoscopic training programme. We also established a credible pass/fail level using the contrasting groups method. We concluded that the TABTL test could be used to assess novice laparoscopic trainees across different specialties and help trainees acquire basic laparoscopic competencies prior to supervised surgery. In the third study, we aimed to explore the consequences of the choice of standard setting method and whether there is a difference in terms of how high a score experienced and novice laparoscopic surgeons expect that novices should achieve during training. We used three different standard setting methods and found that pass/fail levels vary depending on the choice of standard setting method. We also asked experienced and novice laparoscopic surgeons how high a score they expected a novice laparoscopic surgeon should achieve on a test during training. We found a significant difference, with experienced surgeons setting a lower pass/fail level. We concluded that an established standard setting method supported by evidence should be used when setting a pass/fail level. In the first and second papers of this thesis, we found that off-site training is feasible and explored validity for the TABLT test. We used this knowledge in the fourth study to design a randomised controlled trial. The aim of the trial was to investigate the effect of take-home training in a simulation-based laparoscopic course. We hypothesised that training at home could help trainees plan their training according to their own schedule and thereby increase the effect of training. We found that participants had a distributed training pattern; they trained more frequently and in shorter sessions. We also found that participants were able to rate their own performance during unsupervised training and that selfrating was reliable. The fifth and final study of the thesis was a mixed-methods study that aimed to explore the use of take-home training. To meet this aim, we recruited participants from the intervention arm in our randomised controlled trial. All participants had access to the simulation centre and were given a port-able trainer to train on at home. Participants were asked to use a logbook during training. At the end of the course, they were invited to take part in focus group interviews and individual interviews. Based on data from logbooks, a descriptive statistical analysis was conducted and data from interviews were analysed using a content analysis. We found that participants took an individualised approach to training when training at home. They structured their training according to their needs and external requirements. We concluded that mandatory training requirements and testing help determine when and how much participants train. We also found that self-rating can guide unsupervised training by giving clear goals to be reached during training. From the papers included in the thesis, we found that the literature describes training at home as a feasible method of acquiring laparoscopic skills. Nonetheless, changes to current training programmes are needed in order to make this method effective. We then developed and explored validity evidence for the TABLT test. We also established a reasonable pass/fail level and went on to explore the immediate consequences of the pass/fail level. Using our knowledge from the review, we conducted a randomised controlled trial and a mixed-method study. Based on these studies we found that training at home allows for distributed learning, that self-rating guides unsupervised training, and that mandatory training requirements and testing strongly influence training patterns. Access to training, guidance during training, and mandatory training requirements will make take-home training not just feasible but also effective. Articles published in the Danish Medical Journal are “open access”. This means that the articles are distributed under the terms of the Creative Commons Attribution Non-commercial License, which permits any non-commercial use, distribution, and reproduction in any medium, provided the original author(s) and source are credited.

75 FR 75532 - Shipping Coordinating Committee; Notice of Committee Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2010-12-03

...; --Validation of model training courses; --Unlawful practices associated with certificates of competency... Recommendations for entering enclosed spaces aboard ships; --Development of model procedures for executing shipboard emergency measures; --Development of training standards for recovery systems; --Development of...

Designing for International Teletraining.

ERIC Educational Resources Information Center

Chute, Alan G.; Shatzer, Linda S.

The ability to bridge together geographically-distant populations for training is made possible through teletraining, a human performance system which integrates telecommunications into the planning, design, and delivery of training programs. Typically, teletraining uses standard telephone lines or digital communication services to provide…

National standards in science education: Teacher perceptions regarding utilization

NASA Astrophysics Data System (ADS)

Fletcher, Carol Louise Parsons

The purpose of this naturalistic study was to determine what factors most influence middle school science teachers' intentions to utilize or ignore national standards, as a toot for reform in their classrooms, schools, or districts. Results indicate. that teachers with. minimal training were unlikely to use national standards documents due to their perceptions of a lack of support from peers, administrators and a high-stakes state accountability system. Teachers with more extensive training were more inclined to use national standards documents as philosophical guides for reform because they believed in the validity of the recommendations. Implications are discussed, chief among them that short-term professional development may actually do more harm than good if teachers retain or develop unexamined misconceptions about national standards recommendations as a result. In addition, due to the concerns expressed by teachers regarding state curriculum mandates and standardized testing, this study indicates that changes in these external factors must be instituted before teachers will commit themselves to standards-based reforms. It is suggested that staff development focus on opportunities for reflection and application which will promote conceptual change in teachers. A model predicated on the notion that the process of implementing reform is essentially an issue of promoting conceptual change in teachers is proposed. This model, termed the Reform Implementation as Conceptual Change, or RICC, focuses specifically on the cognitive processes teachers may go through when they are exposed to an innovation such as national standards. Stages such as integrated application, accommodation, assimilation, disconnection, and false accommodation, are described. The impact that professional development and training may have on the likelihood that teachers will experience these various stages is also discussed. This model serves as a theoretical framework for explaining why some teachers are unlikely to embrace national standards while others choose to utilize them as a tool for reforming science education in their classrooms, schools, or districts. As such, it can be used by reformers to design and diagnostically evaluate the implementation process and its related staff development.

A consensus-based gold standard for the evaluation of mass casualty triage systems.

PubMed

Lerner, E Brooke; McKee, Courtney H; Cady, Charles E; Cone, David C; Colella, M Riccardo; Cooper, Arthur; Coule, Phillip L; Lairet, Julio R; Liu, J Marc; Pirrallo, Ronald G; Sasser, Scott M; Schwartz, Richard; Shepherd, Greene; Swienton, Raymond E

2015-01-01

Accuracy and effectiveness analyses of mass casualty triage systems are limited because there are no gold standard definitions for each of the triage categories. Until there is agreement on which patients should be identified by each triage category, it will be impossible to calculate sensitivity and specificity or to compare accuracy between triage systems. To develop a consensus-based, functional gold standard definition for each mass casualty triage category. National experts were recruited through the lead investigators' contacts and their suggested contacts. Key informant interviews were conducted to develop a list of potential criteria for defining each triage category. Panelists were interviewed in order of their availability until redundancy of themes was achieved. Panelists were blinded to each other's responses during the interviews. A modified Delphi survey was developed with the potential criteria identified during the interview and delivered to all recruited experts. In the early rounds, panelists could add, remove, or modify criteria. In the final rounds edits were made to the criteria until at least 80% agreement was achieved. Thirteen national and local experts were recruited to participate in the project. Six interviews were conducted. Three rounds of voting were performed, with 12 panelists participating in the first round, 12 in the second round, and 13 in the third round. After the first two rounds, the criteria were modified according to respondent suggestions. In the final round, over 90% agreement was achieved for all but one criterion. A single e-mail vote was conducted on edits to the final criterion and consensus was achieved. A consensus-based, functional gold standard definition for each mass casualty triage category was developed. These gold standard definitions can be used to evaluate the accuracy of mass casualty triage systems after an actual incident, during training, or for research.

Helicopter simulator standards

NASA Technical Reports Server (NTRS)

Boothe, Edward M.

1992-01-01

The initial advisory circular was produced in 1984 (AC 120-XX). It was not finalized, however, because the FAR's for pilot certification did not recognize helicopter simulators and, therefore, permitted no credit for their use. That is being rectified, and, when the new rules are published, standards must be available for qualifying simulators. Because of the lack of a data base to support specification of these standards, the FAA must rely on the knowledge of experts in the simulator/training industry. A major aim of this workshop is to form a working group of these experts to produce a set of standards for helicopter training simulators.

Effects of auditory radio interference on a fine, continuous, open motor skill.

PubMed

Lazar, J M; Koceja, D M; Morris, H H

1995-06-01

The effects of human speech on a fine, continuous, and open motor skill were examined. A tape of auditory human radio traffic was injected into a tank gunnery simulator during each training session for 4 wk. of training for 3 hr. a week. The dependent variables were identification time, fire time, kill time, systems errors, and acquisition errors. These were measured by the Unit Conduct Of Fire Trainer (UCOFT). The interference was interjected into the UCOFT Tank Table VIII gunnery test. A Solomon four-group design was used. A 2 x 2 analysis of variance was used to assess whether interference gunnery training resulted in improvements in interference posttest scores. During the first three weeks of training, the interference group committed 106% more systems errors and 75% more acquisition errors than the standard group. The interference training condition was associated with a significant improvement from pre- to posttest of 44% in over-all UCOFT scores; however, when examined on the posttest the standard training did not improve performance significantly over the same period. It was concluded that auditory radio interference degrades performance of this fine, continuous, open motor skill, and interference training appears to abate the effects of this degradation.

Specificity of Occupational Training and Occupational Mobility: An Empirical Study Based on Lazear's Skill-Weights Approach

ERIC Educational Resources Information Center

Geel, Regula; Mure, Johannes; Backes-Gellner, Uschi

2011-01-01

According to standard human capital theory, firm-financed training cannot be explained if the skills obtained are general in nature. Nevertheless, in German-speaking countries, firms invest heavily in apprenticeship training although the skills are assumed to be general. In our paper, we study the extent to which apprenticeship training is general…

MITT writer and MITT writer advanced development: Developing authoring and training systems for complex technical domains

NASA Technical Reports Server (NTRS)

Wiederholt, Bradley J.; Browning, Elica J.; Norton, Jeffrey E.; Johnson, William B.

1991-01-01

MITT Writer is a software system for developing computer based training for complex technical domains. A training system produced by MITT Writer allows a student to learn and practice troubleshooting and diagnostic skills. The MITT (Microcomputer Intelligence for Technical Training) architecture is a reasonable approach to simulation based diagnostic training. MITT delivers training on available computing equipment, delivers challenging training and simulation scenarios, and has economical development and maintenance costs. A 15 month effort was undertaken in which the MITT Writer system was developed. A workshop was also conducted to train instructors in how to use MITT Writer. Earlier versions were used to develop an Intelligent Tutoring System for troubleshooting the Minuteman Missile Message Processing System.

The effects of scenario-based simulation course training on nurses' communication competence and self-efficacy: a randomized controlled trial.

PubMed

Hsu, Li-Ling; Chang, Wen-Hui; Hsieh, Suh-Ing

2015-01-01

Studies have shown that an underappreciation of the importance of person-centered communication and inappropriate communication training could result in unsatisfactory communication performance from nurses. There are a large number of studies about communication training for nurses, but not so many about communication training in early stages of nursing career. The purpose of this study is to compare the effect of a traditional course versus scenario-based simulation training on nurses' communication competency, communication self-efficacy, and communication performance in discharge planning Objective Structured Clinical Examination (OSCE). A randomized controlled trial was used with a pretest and two posttests. The experimental group underwent the scenario-based simulation course, whereas the control group received the traditional course. A convenience sample of 116 nurses with qualifications ranging from N0 level (novice nurses) to N2 level (competent nurses) in Taiwan's clinical nursing ladder system was recruited from a medical center in northern Taiwan. Analysis of covariance was used to determine between-subjects effects on communication competency and self-efficacy, whereas independent t test and Mann-Whitney U test were used to examine between-subjects effects on learner satisfaction and discharge planning communication performance. Paired t test was used to determine communication self-efficacy. In this study, the nurses and independent raters found scenario-based simulation training more effective than traditional communication course. However, standardized patients reported no significant difference in communication performance between the two groups of nurses. Despite that traditional classroom lectures and simulation-based communication training could both produce enhanced communication competency and self-efficacy among nurses, this study has established that the latter may be better than the former in terms of learner satisfaction and communication performance improvement. Therefore, introduction of simulation-based training to in-service nursing education could enhance nurses' communication performance in clinical practice. Copyright © 2015 Elsevier Inc. All rights reserved.

Impact of relaxation training according to Yoga In Daily Life® system on perceived stress after breast cancer surgery.

PubMed

Kovačič, Tine; Kovačič, Miha

2011-03-01

The purpose of this pilot study was to gather information on the immediate and short-term effects of relaxation training according to Yoga In Daily Life(®) (YIDL) system on the psychological distress of breast cancer patients. 32 patients at the Institute for Oncology of Ljubljana were randomized to the experimental (N=16) and to the control group (N=16). Both groups received the same standard physiotherapy for 1 week, while the experimental group additionally received a group relaxation training sessions according to YIDL(®) system. At discharge the experimental group was issued with audiocassette recordings containing the similar instructions for relaxation training to be practiced individually at home (for further 3 weeks). An experimental repeated measures design was used to investigate the differences over 1 month period in stress levels, changes in mental health and psychological parameters. Measures were obtained at three time points during the study period: baseline, at 1 week, and at 4 weeks, by blinded investigators using standardized questionnaires General Health Questionnaire-12 (GHQ-12), Rotterdam Symptom Checklist (RSCL) psychological subscale, Perceived Stress Scale (PSS). Patients who received relaxation training reported feeling significantly less distressed during hospitalization and after discharge-period than did the controls that did not receive relaxation training. The results indicate that relaxation training according to Yoga in Daily Life(®) system could be useful clinical physiotherapy intervention for breast cancer patients experiencing psychological distress. Although this kind of relaxation training can be applied to clinical oncology in Slovenia, more studies need to be done. © The Author(s) 2011

Variation in Aptitude of Trainees in Endoscopic Ultrasonography, Based on Cumulative Sum Analysis

PubMed Central

Wani, Sachin; Hall, Matthew; Keswani, Rajesh N.; Aslanian, Harry R.; Casey, Brenna; Burbridge, Rebecca; Chak, Amitabh; Chen, Ann M.; Cote, Gregory; Edmundowicz, Steven A.; Faulx, Ashley L.; Hollander, Thomas G.; Lee, Linda S.; Mullady, Daniel; Murad, Faris; Muthusamy, Raman; Pfau, Patrick R.; Scheiman, James M.; Tokar, Jeffrey; Wagh, Mihir S.; Watson, Rabindra; Early, Dayna

2017-01-01

BACKGROUND & AIMS Studies have reported substantial variation in the competency of advanced endoscopy trainees, indicating a need for more supervised training in endoscopic ultrasound (EUS). We used a standardized, validated, data collection tool to evaluate learning curves and measure competency in EUS among trainees at multiple centers. METHODS In a prospective study performed at 15 centers, 17 trainees with no prior EUS experience were evaluated by experienced attending endosonographers at the 25th and then every 10th upper EUS examination, over a 12-month training period. A standardized data collection form was used (using a 5-point scoring system) to grade the EUS examination. Cumulative sum analysis was applied to produce a learning curve for each trainee; it tracked the overall performance based on median scores at different stations and also at each station. Competency was defined by a median score of 1, with acceptable and unacceptable failure rates of 10% and 20%, respectively. RESULTS Twelve trainees were included in the final analysis. Each of the trainees performed 265 to 540 EUS examinations (total, 4257 examinations). There was a large amount of variation in their learning curves: 2 trainees crossed the threshold for acceptable performance (at cases 225 and 245), 2 trainees had a trend toward acceptable performance (after 289 and 355 cases) but required continued observation, and 8 trainees needed additional training and observation. Similar results were observed at individual stations. CONCLUSIONS A specific case load does not ensure competency in EUS; 225 cases should be considered the minimum caseload for training because we found that no trainee achieved competency before this point. Ongoing training should be provided for trainees until competency is confirmed using objective measures. PMID:25460557

Variation in Aptitude of Trainees in Endoscopic Ultrasonography, Based on Cumulative Sum Analysis.

PubMed

Wani, Sachin; Hall, Matthew; Keswani, Rajesh N; Aslanian, Harry R; Casey, Brenna; Burbridge, Rebecca; Chak, Amitabh; Chen, Ann M; Cote, Gregory; Edmundowicz, Steven A; Faulx, Ashley L; Hollander, Thomas G; Lee, Linda S; Mullady, Daniel; Murad, Faris; Muthusamy, V Raman; Pfau, Patrick R; Scheiman, James M; Tokar, Jeffrey; Wagh, Mihir S; Watson, Rabindra; Early, Dayna

2015-07-01

Studies have reported substantial variation in the competency of advanced endoscopy trainees, indicating a need for more supervised training in endoscopic ultrasound (EUS). We used a standardized, validated, data collection tool to evaluate learning curves and measure competency in EUS among trainees at multiple centers. In a prospective study performed at 15 centers, 17 trainees with no prior EUS experience were evaluated by experienced attending endosonographers at the 25th and then every 10th upper EUS examination, over a 12-month training period. A standardized data collection form was used (using a 5-point scoring system) to grade the EUS examination. Cumulative sum analysis was applied to produce a learning curve for each trainee; it tracked the overall performance based on median scores at different stations and also at each station. Competency was defined by a median score of 1, with acceptable and unacceptable failure rates of 10% and 20%, respectively. Twelve trainees were included in the final analysis. Each of the trainees performed 265 to 540 EUS examinations (total, 4257 examinations). There was a large amount of variation in their learning curves: 2 trainees crossed the threshold for acceptable performance (at cases 225 and 245), 2 trainees had a trend toward acceptable performance (after 289 and 355 cases) but required continued observation, and 8 trainees needed additional training and observation. Similar results were observed at individual stations. A specific case load does not ensure competency in EUS; 225 cases should be considered the minimum caseload for training because we found that no trainee achieved competency before this point. Ongoing training should be provided for trainees until competency is confirmed using objective measures. Copyright © 2015 AGA Institute. Published by Elsevier Inc. All rights reserved.

Surgical simulation: Current practices and future perspectives for technical skills training.

PubMed

Bjerrum, Flemming; Thomsen, Ann Sofia Skou; Nayahangan, Leizl Joy; Konge, Lars

2018-06-17

Simulation-based training (SBT) has become a standard component of modern surgical education, yet successful implementation of evidence-based training programs remains challenging. In this narrative review, we use Kern's framework for curriculum development to describe where we are now and what lies ahead for SBT within surgery with a focus on technical skills in operative procedures. Despite principles for optimal SBT (proficiency-based, distributed, and deliberate practice) having been identified, massed training with fixed time intervals or a fixed number of repetitions is still being extensively used, and simulators are generally underutilized. SBT should be part of surgical training curricula, including theoretical, technical, and non-technical skills, and be based on relevant needs assessments. Furthermore, training should follow evidence-based theoretical principles for optimal training, and the effect of training needs to be evaluated using relevant outcomes. There is a larger, still unrealized potential of surgical SBT, which may be realized in the near future as simulator technologies evolve, more evidence-based training programs are implemented, and cost-effectiveness and impact on patient safety is clearly demonstrated.

Abortion training at multiple sites: an unexpected curriculum for teaching systems-based practice.

PubMed

Herbitter, Cara; Kumar, Vanita; Karasz, Alison; Gold, Marji

2010-04-01

In 1999, the Accreditation Council for Graduate Medical Education endorsed systems-based practice as one of six general competencies. The objective is to explore the paradigm of teaching residents systems-based practice during a women's health rotation that included abortion training in multiple settings. During a routine women's health rotation, residents from two urban family medicine residency programs received early abortion training at a high-volume abortion clinic and their continuity clinic. Thirty-min semistructured interviews were conducted with all 26 residents who rotated between July 2005 and August 2006. Transcripts were analyzed using thematic codes. Through exposure to different healthcare delivery systems, residents learned about systems-based practice, including understanding the failure of the larger system to meet patients' reproductive healthcare needs, differences between two systems, and potential systems barriers they might face as providers. Abortion training in multiple settings may serve as a paradigm for teaching systems-based practice during other rotations that include training in multiple sites.

Fault-tolerant nonlinear adaptive flight control using sliding mode online learning.

PubMed

Krüger, Thomas; Schnetter, Philipp; Placzek, Robin; Vörsmann, Peter

2012-08-01

An expanded nonlinear model inversion flight control strategy using sliding mode online learning for neural networks is presented. The proposed control strategy is implemented for a small unmanned aircraft system (UAS). This class of aircraft is very susceptible towards nonlinearities like atmospheric turbulence, model uncertainties and of course system failures. Therefore, these systems mark a sensible testbed to evaluate fault-tolerant, adaptive flight control strategies. Within this work the concept of feedback linearization is combined with feed forward neural networks to compensate for inversion errors and other nonlinear effects. Backpropagation-based adaption laws of the network weights are used for online training. Within these adaption laws the standard gradient descent backpropagation algorithm is augmented with the concept of sliding mode control (SMC). Implemented as a learning algorithm, this nonlinear control strategy treats the neural network as a controlled system and allows a stable, dynamic calculation of the learning rates. While considering the system's stability, this robust online learning method therefore offers a higher speed of convergence, especially in the presence of external disturbances. The SMC-based flight controller is tested and compared with the standard gradient descent backpropagation algorithm in the presence of system failures. Copyright © 2012 Elsevier Ltd. All rights reserved.

Power train and emission control: allocation procedure by OBD-II system for automotive technology

NASA Astrophysics Data System (ADS)

Kalita, Porag

2017-06-01

OBD-II, systems were designed to maintain low emissions of in use vehicles, including light and medium duty vehicles. In 1989, the California code of Regulations (CCR) known as OBD - II was adopted by the California Air Resource Board (CARB) and the objective to reduce hydrocarbon (HC) emission caused by malfunction of the vehicles emission control systems. OBD-II provides additional information to engineer for diagnosis and repair of emissions related problems. OBD-II, standardizes on the amount of memory (Freeze Frame) it uses to store the readings of the vehicle sensor when it logs on emission related Intermittent Trouble code (IT). The intent of OBD-II, systems is to detect most vehicle malfunctions when performance of a power train component or system deteriorates to the point that the vehicle’s HC emission exceed standard. The vehicle operator is notified at the time when the vehicle begins to marginally exceed emission standards, by illuminating the Malfunctions Indicator Light (MIL).

Managers’ Perceptions of the Value and Impact of HAZWOPER Worker Health and Safety Training

PubMed Central

Riley, Kevin; Slatin, Craig; Rice, Carol; Rosen, Mitchel; Weidner, B. Louise; Fleishman, Jane; Alerding, Linda; Delp, Linda

2018-01-01

Background Worker training is a core component of the OSHA Hazardous Waste Operations and Emergency Response (HAZWOPER) standard, but few studies have considered what motivates managers to provide HAZWOPER training to employees or what they value in that training. Methods In 2012, four university-based programs conducted an exploratory survey of managers who sent employees to HAZWOPER courses. Results from 109 respondents were analyzed. Results Forty-two percent of respondents cited regulations as the most important reason to provide HAZWOPER training; many indicated they would provide less training if there were no standard in place. Three-quarters (74%) reported training had improved workplace conditions. Fewer than half said they were likely to involve trained employees in aspects of the organization’s H&S program. Discussion Compliance with regulatory requirements is an important factor shaping managers’ training delivery decisions. Managers recognize positive impacts of training. These impacts could be enhanced by further leveraging employee H&S knowledge and skills. PMID:26010141

Managers' perceptions of the value and impact of HAZWOPER worker health and safety training.

PubMed

Riley, Kevin; Slatin, Craig; Rice, Carol; Rosen, Mitchel; Weidner, B Louise; Fleishman, Jane; Alerding, Linda; Delp, Linda

2015-07-01

Worker training is a core component of the OSHA Hazardous Waste Operations and Emergency Response (HAZWOPER) standard, but few studies have considered what motivates managers to provide HAZWOPER training to employees or what they value in that training. In 2012, four university-based programs conducted an exploratory survey of managers who sent employees to HAZWOPER courses. Results from 109 respondents were analyzed. Forty-two percent of respondents cited regulations as the most important reason to provide HAZWOPER training; many indicated they would provide less training if there were no standard in place. Three-quarters (74%) reported training had improved workplace conditions. Fewer than half said they were likely to involve trained employees in aspects of the organization's H&S program. Compliance with regulatory requirements is an important factor shaping managers' training delivery decisions. Managers recognize positive impacts of training. These impacts could be enhanced by further leveraging employee H&S knowledge and skills. © 2015 Wiley Periodicals, Inc.

Computational Methods to Predict Protein Interaction Partners

NASA Astrophysics Data System (ADS)

Valencia, Alfonso; Pazos, Florencio

In the new paradigm for studying biological phenomena represented by Systems Biology, cellular components are not considered in isolation but as forming complex networks of relationships. Protein interaction networks are among the first objects studied from this new point of view. Deciphering the interactome (the whole network of interactions for a given proteome) has been shown to be a very complex task. Computational techniques for detecting protein interactions have become standard tools for dealing with this problem, helping and complementing their experimental counterparts. Most of these techniques use genomic or sequence features intuitively related with protein interactions and are based on "first principles" in the sense that they do not involve training with examples. There are also other computational techniques that use other sources of information (i.e. structural information or even experimental data) or are based on training with examples.

Solving the master equation without kinetic Monte Carlo: Tensor train approximations for a CO oxidation model

NASA Astrophysics Data System (ADS)

Gelß, Patrick; Matera, Sebastian; Schütte, Christof

2016-06-01

In multiscale modeling of heterogeneous catalytic processes, one crucial point is the solution of a Markovian master equation describing the stochastic reaction kinetics. Usually, this is too high-dimensional to be solved with standard numerical techniques and one has to rely on sampling approaches based on the kinetic Monte Carlo method. In this study we break the curse of dimensionality for the direct solution of the Markovian master equation by exploiting the Tensor Train Format for this purpose. The performance of the approach is demonstrated on a first principles based, reduced model for the CO oxidation on the RuO2(110) surface. We investigate the complexity for increasing system size and for various reaction conditions. The advantage over the stochastic simulation approach is illustrated by a problem with increased stiffness.

A Kinect-based system for automatic recording of some pigeon behaviors.

PubMed

Lyons, Damian M; MacDonall, James S; Cunningham, Kelly M

2015-12-01

Contact switches and touch screens are the state of the art for recording pigeons' pecking behavior. Recording other behavior, however, requires a different sensor for each behavior, and some behaviors cannot easily be recorded. We present a flexible and inexpensive image-based approach to detecting and counting pigeon behaviors that is based on the Kinect sensor from Microsoft. Although the system is as easy to set up and use as the standard approaches, it is more flexible because it can record behaviors in addition to key pecking. In this article, we show how both the fast, fine motion of key pecking and the gross body activity of feeding can be measured. Five pigeons were trained to peck at a lighted contact switch, a pigeon key, to obtain food reward. The timing of the pecks and the food reward signals were recorded in a log file using standard equipment. The Kinect-based system, called BehaviorWatch, also measured the pecking and feeding behavior and generated a different log file. For key pecking, BehaviorWatch had an average sensitivity of 95% and a precision of 91%, which were very similar to the pecking measurements from the standard equipment. For detecting feeding activity, BehaviorWatch had a sensitivity of 95% and a precision of 97%. These results allow us to demonstrate that an advantage of the Kinect-based approach is that it can also be reliably used to measure activity other than key pecking.

Virtual reality-based medical training and assessment: The multidisciplinary relationship between clinicians, educators and developers.

PubMed

Lövquist, Erik; Shorten, George; Aboulafia, Annette

2012-01-01

The current focus on patient safety and evidence-based medical education has led to an increased interest in utilising virtual reality (VR) for medical training. The development of VR-based systems require experts from different disciplines to collaborate with shared and agreed objectives throughout a system's development process. Both the development of technology as well as the incorporation and evaluation of relevant training have to be given the appropriate attention. The aim of this article is to illustrate how constructive relationships can be established between stakeholders to develop useful and usable VR-based medical training systems. This article reports a case study of two research projects that developed and evaluated a VR-based training system for spinal anaesthesia. The case study illustrates how close relationships can be established by champion clinicians leading research in this area and by closely engaging clinicians and educators in iterative prototype design throughout a system's development process. Clinicians and educators have to strive to get more involved (ideally as champions of innovation) and actively guide the development of VR-based training and assessment systems. System developers have to strive to ensure that clinicians and educators are participating constructively in the developments of such systems.

The 2009 DOD Cost Research Workshop: Acquisition Reform

DTIC Science & Technology

2010-02-01

2 ACEIT Enhancement, Help-Desk/Training, Consulting DASA-CE–3 Command, Control, Communications, Computers, Intelligence, Surveillance, and...Management Information System (OSMIS) online interactive relational database DASA-CE–2 Title: ACEIT Enhancement, Help-Desk/Training, Consulting Summary...support and training for the Automated Cost estimator Integrated Tools ( ACEIT ) software suite. ACEIT is the Army standard suite of analytical tools for

49 CFR 236.714 - Cab.

Code of Federal Regulations, 2010 CFR

2010-10-01

... TRANSPORTATION RULES, STANDARDS, AND INSTRUCTIONS GOVERNING THE INSTALLATION, INSPECTION, MAINTENANCE, AND REPAIR OF SIGNAL AND TRAIN CONTROL SYSTEMS, DEVICES, AND APPLIANCES Definitions § 236.714 Cab. The compartment of a locomotive from which the propelling power and power brakes of the train are manually...

Raster Scan Computer Image Generation (CIG) System Based On Refresh Memory

NASA Astrophysics Data System (ADS)

Dichter, W.; Doris, K.; Conkling, C.

1982-06-01

A full color, Computer Image Generation (CIG) raster visual system has been developed which provides a high level of training sophistication by utilizing advanced semiconductor technology and innovative hardware and firmware techniques. Double buffered refresh memory and efficient algorithms eliminate the problem of conventional raster line ordering by allowing the generated image to be stored in a random fashion. Modular design techniques and simplified architecture provide significant advantages in reduced system cost, standardization of parts, and high reliability. The major system components are a general purpose computer to perform interfacing and data base functions; a geometric processor to define the instantaneous scene image; a display generator to convert the image to a video signal; an illumination control unit which provides final image processing; and a CRT monitor for display of the completed image. Additional optional enhancements include texture generators, increased edge and occultation capability, curved surface shading, and data base extensions.

OSA severity assessment based on sleep breathing analysis using ambient microphone.

PubMed

Dafna, E; Tarasiuk, A; Zigel, Y

2013-01-01

In this paper, an audio-based system for severity estimation of obstructive sleep apnea (OSA) is proposed. The system estimates the apnea-hypopnea index (AHI), which is the average number of apneic events per hour of sleep. This system is based on a Gaussian mixture regression algorithm that was trained and validated on full-night audio recordings. Feature selection process using a genetic algorithm was applied to select the best features extracted from time and spectra domains. A total of 155 subjects, referred to in-laboratory polysomnography (PSG) study, were recruited. Using the PSG's AHI score as a gold-standard, the performances of the proposed system were evaluated using a Pearson correlation, AHI error, and diagnostic agreement methods. Correlation of R=0.89, AHI error of 7.35 events/hr, and diagnostic agreement of 77.3% were achieved, showing encouraging performances and a reliable non-contact alternative method for OSA severity estimation.

Explosive detection systems data collection final report

DTIC Science & Technology

2016-10-01

Institute of Standards and Technology (NIST) project to develop standards for bomb squad operators. Under this effort, ARA was tasked with developing and...Collection (EDSDC) ................................................................ 5    DHS/NIST Support ( Bomb Squad Robotic Training Standards...Development ................................................................................................ 5  Figure 3. Layout of the Bomb Squad Test

Corporate compliance: framework and implementation.

PubMed

Fowler, N

1999-01-01

The federal government has created numerous programs to combat fraud and abuse. The government now encourages healthcare facilities to have a corporate compliance program (CCP), a plan that reduces the chances that the facility will violate laws or regulations. A CCP is an organization-wide program comprised of a code of conduct and written policies, internal monitoring and auditing standards, employee training, feedback mechanisms and other features, all designed to prevent and detect violations of governmental laws, regulations and policies. It is a system or method ensuring that employees understand and will comply with laws that apply to what they do every day. Seven factors, based on federal sentencing guidelines, provide the framework for developing a CCP. First, a facility must establish rules that are reasonably capable of reducing criminal conduct. Second, high-level personnel must oversee the compliance effort. Third, a facility must use due care in delegating authority in the compliance initiative. Fourth, standards must be communicated effectively to employees, and fifth, a facility must take reasonable steps to achieve compliance. Sixth, standards must be enforced consistently across the organization and last, standards must be modified or changed for reported concerns, to ensure they are not repeated. PROMINA Health System, Inc. in Atlanta, Ga., designed a program to meet federal guidelines. It started with a self-assessment to define its areas or risk. Next, it created the internal structure and assigned organizational responsibility for running the CCP. PROMINA then developed standards of business and professional conduct, established vehicles of communication and trained employees on the standards. Finally, it continues to develop evidence of the program's effectiveness by monitoring and documenting its compliance activities.

Evaluation of a Technology-Based Adaptive Learning and Prevention Program for Stress Response-A Randomized Controlled Trial.

PubMed

Wesemann, Ulrich; Kowalski, Jens T; Jacobsen, Thomas; Beudt, Susan; Jacobs, Herbert; Fehr, Julia; Büchler, Jana; Zimmermann, Peter L

2016-08-01

To prevent deployment-related disorders, Chaos Driven Situations Management Retrieval System (CHARLY), a computer-aided training platform with a biofeedback interface has been developed. It simulates critical situations photorealistic for certain target and occupational groups. CHARLY was evaluated as a 1.5 days predeployment training method comparing it with the routine training. The evaluation was carried out for a matched random sample of N = 67 soldiers deployed in Afghanistan (International Security Assistance Force). Data collection took place before and after the prevention program and 4 to 6 weeks after deployment, which included mental state, post-traumatic stress disorder (PTSD) symptoms, knowledge of and attitude toward PTSD, and deployment-specific stressors. CHARLY has been significantly superior to the control group in terms of psychoeducation and attitude change. As to the mental state, both groups showed a significant increase in stress after deployment with significant lower increase in CHARLY. For PTSD-specific symptoms, CHARLY achieved a significant superiority. The fact that PTSD-specific scales showed significant differences at the end of deployment substantiates the validity of a specifically preventive effect of CHARLY. The study results tentatively indicate that highly standardized, computer-based primary prevention of mental disorders in soldiers on deployment might be superior to other more personal and less standardized forms of prevention. Reprint & Copyright © 2016 Association of Military Surgeons of the U.S.

Finger language recognition based on ensemble artificial neural network learning using armband EMG sensors.

PubMed

Kim, Seongjung; Kim, Jongman; Ahn, Soonjae; Kim, Youngho

2018-04-18

Deaf people use sign or finger languages for communication, but these methods of communication are very specialized. For this reason, the deaf can suffer from social inequalities and financial losses due to their communication restrictions. In this study, we developed a finger language recognition algorithm based on an ensemble artificial neural network (E-ANN) using an armband system with 8-channel electromyography (EMG) sensors. The developed algorithm was composed of signal acquisition, filtering, segmentation, feature extraction and an E-ANN based classifier that was evaluated with the Korean finger language (14 consonants, 17 vowels and 7 numbers) in 17 subjects. E-ANN was categorized according to the number of classifiers (1 to 10) and size of training data (50 to 1500). The accuracy of the E-ANN-based classifier was obtained by 5-fold cross validation and compared with an artificial neural network (ANN)-based classifier. As the number of classifiers (1 to 8) and size of training data (50 to 300) increased, the average accuracy of the E-ANN-based classifier increased and the standard deviation decreased. The optimal E-ANN was composed with eight classifiers and 300 size of training data, and the accuracy of the E-ANN was significantly higher than that of the general ANN.

Rasmussen's model of human behavior in laparoscopy training.

PubMed

Wentink, M; Stassen, L P S; Alwayn, I; Hosman, R J A W; Stassen, H G

2003-08-01

Compared to aviation, where virtual reality (VR) training has been standardized and simulators have proven their benefits, the objectives, needs, and means of VR training in minimally invasive surgery (MIS) still have to be established. The aim of the study presented is to introduce Rasmussen's model of human behavior as a practical framework for the definition of the training objectives, needs, and means in MIS. Rasmussen distinguishes three levels of human behavior: skill-, rule-, and knowledge-based behaviour. The training needs of a laparoscopic novice can be determined by identifying the specific skill-, rule-, and knowledge-based behavior that is required for performing safe laparoscopy. Future objectives of VR laparoscopy trainers should address all three levels of behavior. Although most commercially available simulators for laparoscopy aim at training skill-based behavior, especially the training of knowledge-based behavior during complications in surgery will improve safety levels. However, the cost and complexity of a training means increases when the training objectives proceed from the training of skill-based behavior to the training of complex knowledge-based behavior. In aviation, human behavior models have been used successfully to integrate the training of skill-, rule-, and knowledge-based behavior in a full flight simulator. Understanding surgeon behavior is one of the first steps towards a future full-scale laparoscopy simulator.

Comparative Analysis of Future Cooks' Training in Vocational Institutions in Ukraine and Abroad

ERIC Educational Resources Information Center

Kankovsky, Ihor; Krasylnykova, Hanna; Drozich, Iryna

2017-01-01

The article deals with comparative analysis of conceptual approaches and content of cooks' training in Ukraine, European countries, the USA and Eastern Partnership countries. It has been found out that national vocational education is grounded on education standards and activity-based approach to forming the training content, subject-based…

78 FR 1256 - Guam Military Base Realignment Contractor Recruitment Standards

Federal Register 2010, 2011, 2012, 2013, 2014

2013-01-08

... Contractor Recruitment Standards AGENCY: Employment and Training Administration, Labor. ACTION: Final notice... issuing this notice to announce recruitment standards that construction contractors are required to follow... B) by adding a new subsection (6). This provision prohibits contractors engaged in construction...

77 FR 3503 - Guam Military Base Realignment Contractor Recruitment Standards

Federal Register 2010, 2011, 2012, 2013, 2014

2012-01-24

... Contractor Recruitment Standards AGENCY: Employment and Training Administration, Labor. ACTION: Notice... issuing this notice to announce the recruitment standards that construction contractors are required to... contractors engaged in construction projects related to the realignment of U.S. military forces from Okinawa...

Geomatics Education: Need Assessment

NASA Astrophysics Data System (ADS)

Vyas, A.

2014-11-01

Education system is divided in to two classes: formal and informal. Formal education establishes the basis of theory and practical learning whereas informal education is largely self-learning, learning from real world projects. Generally science and technology streams require formal method of education. The social and related aspects can be taught through the other methods. Education is a media through which the foundation of the knowledge and skill is built. The statistics reveals the increase in the trend of the literate population. This may be accounted due to the level of urbanization and migration to the cities in search for the "white-collar jobs". As a result, a shift in the employment structure is observed from a primary sector to a secondary and tertiary sector. Thomas Friedman in his book `The World is Flat' quotes the impact of globalization on adaptation of science and technology, the world has become large to tiny. One of the technologies to mention here is geospatial technology. With the advancement in the satellite remote sensing, geographical information system, global positioning system, the database management system has become important subject areas. The countries are accounting hugh budget on the space technology, which includes education, training and research. Today many developing countries do not have base maps, they are lacking in the systemic data and record keeping, which are essential for governance, decision making and other development purpose. There is no trained manpower available. There is no standard hardware and software identified. An imbalance is observed when the government is promoting the use of geospatial technology, there is no trained manpower nor the availability of the experts to review the accurateness of the spatial data developed. There are very few universities which impart the degree level education, there are very few trained faculty members who give standard education, there exists a lack of standard syllabus. On the other hand, the industry requires high skilled manpower, high experienced manpower. This is a low equilibrium situation. Since the need is enhancing day by day, the shortage of the skilled manpower is increasing, the need of the geomatics education emerges. This paper researches on the need assessment of the education in geospatial specialization. It emphasises on the challenges and issues prevail in geospatial education and in the specialized fields of remote sensing and GIS. This paper analyse the need assessment through all the three actors: government, geospatial industry and education institutions.

Performance of cardiopulmonary resuscitation feedback systems in a long-distance train with distributed traction.

PubMed

González-Otero, Digna M; de Gauna, Sofía Ruiz; Ruiz, Jesus; Rivero, Raquel; Gutierrez, J J; Saiz, Purificación; Russell, James K

2018-04-20

Out-of-hospital cardiac arrest is common in public locations, including public transportation sites. Feedback devices are increasingly being used to improve chest-compression quality. However, their performance during public transportation has not been studied yet. To test two CPR feedback devices representative of the current technologies (accelerometer and electromag- netic-field) in a long-distance train. Volunteers applied compressions on a manikin during the train route using both feedback devices. Depth and rate measurements computed by the devices were compared to the gold-standard values. Sixty-four 4-min records were acquired. The accelerometer-based device provided visual help in all experiments. Median absolute errors in depth and rate were 2.4 mm and 1.3 compressions per minute (cpm) during conventional speed, and 2.5 mm and 1.2 cpm during high speed. The electromagnetic-field-based device never provided CPR feedback; alert messages were shown instead. However, measurements were stored in its internal memory. Absolute errors for depth and rate were 2.6 mm and 0.7 cpm during conventional speed, and 2.6 mm and 0.7 cpm during high speed. Both devices were accurate despite the accelerations and the electromagnetic interferences induced by the train. However, the electromagnetic-field-based device would require modifications to avoid excessive alerts impeding feedback.

Training and professional profile of retinologists in Spain: Retina 2 project, Report 4.

PubMed

Pastor, J Carlos; Fernández, Itziar; Rojas, Jimena; Coco, Rosa; Sanabria, Maria R; Rodríguez-de la Rúa, Enrique; Sánchez, Diego; Valverde, Carmen; Sala-Puigdollers, Anna

2011-01-01

Uniform postresidency systems to train medical specialists have not been developed in most European countries. Before developing a framework for such a system, we established the learning and professional profiles of Spanish ophthalmologists dedicated to medical retina and vitreoretina subspecialties. After identification of presumed subspecialists by experts from different autonomous regions, a self-administered questionnaire was mailed in 2006. A reminder was sent three weeks later. Postal mail was used. Nonresponder bias was determined. Of 492 possible retina subspecialists, 261 replied to the questionnaires. While about 86% received specific retinal training, standardized fellowship programs were uncommon for both medical retina and vitreoretina (around 10%). Of the responders, 24.5% performed only medical retina, 11.8% vitreoretina, and 63.6% both. Most (60.5%) practiced anterior segment surgery, and 78.7% declared skills in vitrectomy. We have developed a database of Spanish ophthalmologists dedicated to retinal pathologies and identified some characteristics of their professional profile. Although most of them have received specific retinal training, standardized mastership programs are still uncommon. These data will be useful in creating a standardized Retina Mastership, an important goal of the European Higher Education Area.

Examiner Training and Reliability in Two Randomized Clinical Trials of Adult Dental Caries

PubMed Central

Banting, David W.; Amaechi, Bennett T.; Bader, James D.; Blanchard, Peter; Gilbert, Gregg H.; Gullion, Christina M.; Holland, Jan Carlton; Makhija, Sonia K.; Papas, Athena; Ritter, André V.; Singh, Mabi L.; Vollmer, William M.

2013-01-01

Objectives This report describes the training of dental examiners participating in two dental caries clinical trials and reports the inter- and intra- examiner reliability scores from the initial standardization sessions. Methods Study examiners were trained to use a modified ICDAS-II system to detect the visual signs of non-cavitated and cavitated dental caries in adult subjects. Dental caries was classified as no caries (S), non-cavitated caries (D1), enamel caries (D2) and dentine caries (D3). Three standardization sessions involving 60 subjects and 3604 tooth surface calls were used to calculate several measures of examiner reliability. Results The prevalence of dental caries observed in the standardization sessions ranged from 1.4% to 13.5% of the coronal tooth surfaces examined. Overall agreement between pairs of examiners ranged from 0.88 to 0.99. An intra-class coefficient threshold of 0.60 was surpassed for all but one examiner. Inter-examiner unweighted kappa values were low (0.23– 0.35) but weighted kappas and the ratio of observed to maximum kappas were more encouraging (0.42– 0.83). The highest kappa values occurred for the S/D1 vs. D2/D3 two-level classification of dental caries, for which seven of the eight examiners achieved observed to maximum kappa values over 0.90.Intra-examiner reliability was notably higher than inter-examiner reliability for all measures and dental caries classification systems employed. Conclusion The methods and results for the initial examiner training and standardization sessions for two large clinical trials are reported. Recommendations for others planning examiner training and standardization sessions are offered. PMID:22320292

Examiner training and reliability in two randomized clinical trials of adult dental caries.

PubMed

Banting, David W; Amaechi, Bennett T; Bader, James D; Blanchard, Peter; Gilbert, Gregg H; Gullion, Christina M; Holland, Jan Carlton; Makhija, Sonia K; Papas, Athena; Ritter, André V; Singh, Mabi L; Vollmer, William M

2011-01-01

This report describes the training of dental examiners participating in two dental caries clinical trials and reports the inter- and intra-examiner reliability scores from the initial standardization sessions. Study examiners were trained to use a modified International Caries Detection and Assessment System II system to detect the visual signs of non-cavitated and cavitated dental caries in adult subjects. Dental caries was classified as no caries (S), non-cavitated caries (D1), enamel caries (D2), and dentine caries (D3). Three standardization sessions involving 60 subjects and 3,604 tooth surface calls were used to calculate several measures of examiner reliability. The prevalence of dental caries observed in the standardization sessions ranged from 1.4 percent to 13.5 percent of the coronal tooth surfaces examined. Overall agreement between pairs of examiners ranged from 0.88 to 0.99. An intra-class coefficient threshold of 0.60 was surpassed for all but one examiner. Inter-examiner unweighted kappa values were low (0.23-0.35), but weighted kappas and the ratio of observed to maximum kappas were more encouraging (0.42-0.83). The highest kappa values occurred for the S/D1 versus D2/D3 two-level classification of dental caries, for which seven of the eight examiners achieved observed to maximum kappa values over 0.90. Intra-examiner reliability was notably higher than inter-examiner reliability for all measures and dental caries classifications employed. The methods and results for the initial examiner training and standardization sessions for two large clinical trials are reported. Recommendations for others planning examiner training and standardization sessions are offered. © 2011 American Association of Public Health Dentistry.

Computerized Training in Critical Thinking (CT)2: A Skill-Based Program for Army Personnel

DTIC Science & Technology

2008-06-01

15-minute break, and then completed the Skill 8 posttest . After completing the Skill 8 pretest , the experimental group completed the Skill training...including pretests , training modules, and posttests for each of eight CT skills. The pretests and training modules are highly interactive, include...usability evaluations .....................................26 Table 6: Pretest and posttest means and standard deviations by group, investigation 1

A neural network approach for image reconstruction in electron magnetic resonance tomography.

PubMed

Durairaj, D Christopher; Krishna, Murali C; Murugesan, Ramachandran

2007-10-01

An object-oriented, artificial neural network (ANN) based, application system for reconstruction of two-dimensional spatial images in electron magnetic resonance (EMR) tomography is presented. The standard back propagation algorithm is utilized to train a three-layer sigmoidal feed-forward, supervised, ANN to perform the image reconstruction. The network learns the relationship between the 'ideal' images that are reconstructed using filtered back projection (FBP) technique and the corresponding projection data (sinograms). The input layer of the network is provided with a training set that contains projection data from various phantoms as well as in vivo objects, acquired from an EMR imager. Twenty five different network configurations are investigated to test the ability of the generalization of the network. The trained ANN then reconstructs two-dimensional temporal spatial images that present the distribution of free radicals in biological systems. Image reconstruction by the trained neural network shows better time complexity than the conventional iterative reconstruction algorithms such as multiplicative algebraic reconstruction technique (MART). The network is further explored for image reconstruction from 'noisy' EMR data and the results show better performance than the FBP method. The network is also tested for its ability to reconstruct from limited-angle EMR data set.

An embedded system for face classification in infrared video using sparse representation

NASA Astrophysics Data System (ADS)

Saavedra M., Antonio; Pezoa, Jorge E.; Zarkesh-Ha, Payman; Figueroa, Miguel

2017-09-01

We propose a platform for robust face recognition in Infrared (IR) images using Compressive Sensing (CS). In line with CS theory, the classification problem is solved using a sparse representation framework, where test images are modeled by means of a linear combination of the training set. Because the training set constitutes an over-complete dictionary, we identify new images by finding their sparsest representation based on the training set, using standard l1-minimization algorithms. Unlike conventional face-recognition algorithms, we feature extraction is performed using random projections with a precomputed binary matrix, as proposed in the CS literature. This random sampling reduces the effects of noise and occlusions such as facial hair, eyeglasses, and disguises, which are notoriously challenging in IR images. Thus, the performance of our framework is robust to these noise and occlusion factors, achieving an average accuracy of approximately 90% when the UCHThermalFace database is used for training and testing purposes. We implemented our framework on a high-performance embedded digital system, where the computation of the sparse representation of IR images was performed by a dedicated hardware using a deeply pipelined architecture on an Field-Programmable Gate Array (FPGA).

Virtual setting for training in interpreting mammography images

NASA Astrophysics Data System (ADS)

Pezzuol, J. L.; Abreu, F. D. L.; Silva, S. M.; Tendolini, A.; Bissaco, M. A. Se; Rodrigues, S. C. M.

2017-03-01

This work presents a web system for the training of students or residents (users) interested in the detection of breast density in mammography images. The system consists of a breast imaging database with breast density types classified and demarcated by the specialist (tutor) or online database. The planning was based on ISO / IEC 12207. Through the browser (desktop or notebook), the user will visualize the breast images and in them will realize the markings of the density region and even classify them per the BI-RADS protocol. After marking, this will be compared to the gold standard already existing in the image base, and then the system will inform if the area demarcation has been set or not. The shape of this marking is similar to the paint brush. The evaluation was based on ISO / IEC 1926 or 25010: 2011 by 3 software development specialists and 3 in mammary radiology, evaluating usability, configuration, performance and System interface through the Likert scale-based questionnaire. Where they have totally agreed on usability, configuration, performance and partially on the interface. And as a good thing: the system is able to be accessed anywhere and at any time, the hit or error response is in real time, it can be used in the educational area, the limit of the amount of images will depend on the size of the computer memory, At the end the system sends the results achieved by e-mail to the user, reproduction of the system on any type of screen, complementation of the system with other types of breast structures. Negative points are the need for internet.

Systems Engineering Model and Training Application for Desktop Environment

NASA Technical Reports Server (NTRS)

May, Jeffrey T.

2010-01-01

Provide a graphical user interface based simulator for desktop training, operations and procedure development and system reference. This simulator allows for engineers to train and further understand the dynamics of their system from their local desktops. It allows the users to train and evaluate their system at a pace and skill level based on the user's competency and from a perspective based on the user's need. The simulator will not require any special resources to execute and should generally be available for use. The interface is based on a concept of presenting the model of the system in ways that best suits the user's application or training needs. The three levels of views are Component View, the System View (overall system), and the Console View (monitor). These views are portals into a single model, so changing the model from one view or from a model manager Graphical User Interface will be reflected on all other views.

Targeting clinical outcomes: Endovascular simulation improves diagnostic coronary angiography skills.

PubMed

Schimmel, Daniel R; Sweis, Ranya; Cohen, Elaine R; Davidson, Charles; Wayne, Diane B

2016-02-15

The purpose of this study is to determine the effects of simulation-based medical education (SBME) on the skills required to perform coronary angiography in the cardiac catheterization laboratory. Cardiovascular fellows commonly learn invasive procedures on patients. Because this approach is not standardized, it can result in inconsistent skill acquisition through exclusion of concepts and skills. Also, the learning curve varies between trainees yielding variability in skill acquisition. Therefore, coronary angiography skills are an excellent target for SBME in an environment in which direct patient care is not jeopardized. From January 2013 to June 2013, 14 cardiovascular fellows entering the cardiac catheterization laboratory at a tertiary care teaching hospital were tested on an endovascular simulator to assess baseline skills. All fellows subsequently underwent didactic teaching and preceptor-lead training on the endovascular simulator. Topics included basic catheterization skills and a review of catheterization laboratory systems. Following training, all fellows underwent a post-training assessment on the endovascular simulator. Paired t tests were used to compare items on the skills checklist and simulator defined variables. Cardiovascular fellows scored significantly higher on a diagnostic coronary angiography skills checklist following SBME using an endovascular simulator. The mean pretest score was 66.6% (SD = 9.7%) compared to 86.0% (SD = 6.3%) following simulator training (P < 0.001). Additional findings include significant reduction in procedure time and use of cine-fluoroscopy at posttest. SBME significantly improved cardiovascular fellows' performance of simulated coronary angiography skills. Standardized simulation-based education is a valuable adjunct to traditional clinical education for cardiovascular fellows. © 2015 Wiley Periodicals, Inc.

A Usability and Learnability Case Study of Glass Flight Deck Interfaces and Pilot Interactions through Scenario-based Training

NASA Astrophysics Data System (ADS)

De Cino, Thomas J., II

In the aviation industry, digitally produced and presented flight, navigation, and aircraft information is commonly referred to as glass flight decks. Glass flight decks are driven by computer-based subsystems and have long been a part of military and commercial aviation sectors. Over the past 15 years, the General Aviation (GA) sector of the aviation industry has become a recent beneficiary of the rapid advancement of computer-based glass flight deck (GFD) systems. While providing the GA pilot considerable enhancements in the quality of information about the status and operations of the aircraft, training pilots on the use of glass flight decks is often delivered with traditional methods (e.g. textbooks, PowerPoint presentations, user manuals, and limited computer-based training modules). These training methods have been reported as less than desirable in learning to use the glass flight deck interface. Difficulties in achieving a complete understanding of functional and operational characteristics of the GFD systems, acquiring a full understanding of the interrelationships of the varied subsystems, and handling the wealth of flight information provided have been reported. Documented pilot concerns of poor user experience and satisfaction, and problems with the learning the complex and sophisticated interface of the GFD are additional issues with current pilot training approaches. A case study was executed to explore ways to improve training using GFD systems at a Midwestern aviation university. The researcher investigated if variations in instructional systems design and training methods for learning glass flight deck technology would affect the perceptions and attitudes of pilots of the learnability (an attribute of usability) of the glass flight deck interface. Specifically, this study investigated the effectiveness of scenario-based training (SBT) methods to potentially improve pilot knowledge and understanding of a GFD system, and overall pilot user experience and satisfaction. Participants overwhelmingly reported positive learning experiences from scenario-based GFD systems flight training, noting that learning and knowledge construction were improved over other training received in the past. In contrast, participants rated the usability and learnability of the GFD training systems low, reporting various problems with the systems' interface, and the learnability (first-time use) of the complex GFD system. However, issues with usability of the GFD training systems did not reduce or change participant attitudes towards learning and mastering GFD systems; to the contrary, all participants requested additional coursework opportunities to train on GFD systems with the scenario-based flight training format.

Intervention Techniques Used With Autism Spectrum Disorder by Speech-Language Pathologists in the United States and Taiwan: A Descriptive Analysis of Practice in Clinical Settings.

PubMed

Hsieh, Ming-Yeh; Lynch, Georgina; Madison, Charles

2018-04-27

This study examined intervention techniques used with children with autism spectrum disorder (ASD) by speech-language pathologists (SLPs) in the United States and Taiwan working in clinic/hospital settings. The research questions addressed intervention techniques used with children with ASD, intervention techniques used with different age groups (under and above 8 years old), and training received before using the intervention techniques. The survey was distributed through the American Speech-Language-Hearing Association to selected SLPs across the United States. In Taiwan, the survey (Chinese version) was distributed through the Taiwan Speech-Language Pathologist Union, 2018, to certified SLPs. Results revealed that SLPs in the United States and Taiwan used 4 common intervention techniques: Social Skill Training, Augmentative and Alternative Communication, Picture Exchange Communication System, and Social Stories. Taiwanese SLPs reported SLP preparation program training across these common intervention strategies. In the United States, SLPs reported training via SLP preparation programs, peer therapists, and self-taught. Most SLPs reported using established or emerging evidence-based practices as defined by the National Professional Development Center (2014) and the National Standards Report (2015). Future research should address comparison of SLP preparation programs to examine the impact of preprofessional training on use of evidence-based practices to treat ASD.

Public health practitioners' views of the 'Making Every Contact Count' initiative and standards for its evaluation.

PubMed

Chisholm, A; Ang-Chen, P; Peters, S; Hart, J; Beenstock, J

2018-05-30

National Health Service England encourages staff to use everyday interactions with patients to discuss healthy lifestyle changes as part of the 'Making Every Contact Count' (MECC) approach. Although healthcare, government and public health organisations are now expected to adopt this approach, evidence is lacking about how MECC is currently implemented in practice. This study explored the views and experiences of those involved in designing, delivering and evaluating MECC. We conducted a qualitative study using semi-structured interviews with 13 public health practitioners with a range of roles in implementing MECC across England. Interviews were conducted via telephone, transcribed verbatim and analysed using an inductive thematic approach. Four key themes emerged identifying factors accounting for variations in MECC implementation: (i) 'design, quality and breadth of training', (ii) 'outcomes attended to and measured', (iii) 'engagement levels of trainees and trainers' and (iv) 'system-level influences'. MECC is considered a valuable public health approach but because organisations interpret MECC differently, staff training varies in nature. Practitioners believe that implementation can be improved, and an evidence-base underpinning MECC developed, by sharing experiences more widely, introducing standardization to staff training and finding better methods for assessing meaningful outcomes.

Area Determination of Diabetic Foot Ulcer Images Using a Cascaded Two-Stage SVM-Based Classification.

PubMed

Wang, Lei; Pedersen, Peder C; Agu, Emmanuel; Strong, Diane M; Tulu, Bengisu

2017-09-01

The standard chronic wound assessment method based on visual examination is potentially inaccurate and also represents a significant clinical workload. Hence, computer-based systems providing quantitative wound assessment may be valuable for accurately monitoring wound healing status, with the wound area the best suited for automated analysis. Here, we present a novel approach, using support vector machines (SVM) to determine the wound boundaries on foot ulcer images captured with an image capture box, which provides controlled lighting and range. After superpixel segmentation, a cascaded two-stage classifier operates as follows: in the first stage, a set of k binary SVM classifiers are trained and applied to different subsets of the entire training images dataset, and incorrectly classified instances are collected. In the second stage, another binary SVM classifier is trained on the incorrectly classified set. We extracted various color and texture descriptors from superpixels that are used as input for each stage in the classifier training. Specifically, color and bag-of-word representations of local dense scale invariant feature transformation features are descriptors for ruling out irrelevant regions, and color and wavelet-based features are descriptors for distinguishing healthy tissue from wound regions. Finally, the detected wound boundary is refined by applying the conditional random field method. We have implemented the wound classification on a Nexus 5 smartphone platform, except for training which was done offline. Results are compared with other classifiers and show that our approach provides high global performance rates (average sensitivity = 73.3%, specificity = 94.6%) and is sufficiently efficient for a smartphone-based image analysis.

Visual Speech-Training Aid for the Deaf

NASA Technical Reports Server (NTRS)

Miller, Robert J.

1987-01-01

Teaching deaf to speak aided by electronic system provides striking colored, pictorial representation of sound; energy at different frequencies as function of time. Other modalities, such as nasality, intra-oral pressure, and lip-muscle contraction, pictorialized simultaneously. Use of standard components, including personal microcomputer, helps reduce cost below prior voice-training systems. Speech-training system, microphone output separated by filters into narrow frequency bands, changed into digital signals, formatted by computer, and displayed on television screen. Output from other sensors displayed simultaneously or screen split to allow sound produced by student to be compared with that of teacher.

An Audit of Emergency Department Accreditation Based on Joint Commission International Standards (JCI).

PubMed

Hashemi, Behrooz; Motamedi, Maryam; Etemad, Mania; Rahmati, Farhad; Forouzanfar, Mohammad Mehdi; Kaghazchi, Fatemeh

2014-01-01

Despite thousands of years from creation of medical knowledge, it not much passes from founding the health care systems. Accreditation is an effective mechanism for performance evaluation, quality enhancement, and the safety of health care systems. This study was conducted to assess the results of emergency department (ED) accreditation in Shohadaye Tajrish Hospital, Tehran, Iran, 2013 in terms of domesticated standards of joint commission international (JCI) standards. This cohort study with a four-month follow up was conducted in the ED of Shohadaye Tajrish Hospital in 2013. The standard evaluation checklist of Iran hospitals (based on JCI standards) included 24 heading and 337 subheading was used for this purpose. The effective possible causes of weak spots were found and their solutions considered. After correction, assessment of accreditation were repeated again. Finally, the achieved results of two periods were analyzed using SPSS version 20. Quality improvement, admission in department and patient assessment, competency and capability test for staffs, collection and analysis of data, training of patients, and facilities had the score of below 50%. The mean of total score for accreditation in ED in the first period was 60.4±30.15 percent and in the second period 68.9±22.9 (p=0.005). Strategic plans, head of department, head nurse, resident physician, responsible nurse for the shift, and personnel file achieved the score of 100%. Of total headings below 50% in the first period just in two cases, collection and analysis of data with growth of 40% as well as competency and capability test for staffs with growth of 17%, were reached to more than 50%. Based on findings of the present study, the ED of Shohadaye Tajrish hospital reached the score of below 50% in six heading of quality improvement, admission in department and patient assessment, competency and capability test for staffs, collection and analysis of data, training of patients, and facilities. While, the given score in strategic plans, head of department, head nurse, resident physician, responsible nurse for the shifts, and personnel file was 100%.

Strengthening the role of Community Health Representatives in the Navajo Nation.

PubMed

King, Caroline; Goldman, Alex; Gampa, Vikas; Smith, Casey; Muskett, Olivia; Brown, Christian; Malone, Jamy; Sehn, Hannah; Curley, Cameron; Begay, Mae-Gilene; Nelson, Adrianne Katrina; Shin, Sonya Sunhi

2017-04-21

Strengthening Community Health Worker systems has been recognized to improve access to chronic disease prevention and management efforts in low-resource communities. The Community Outreach and Patient Empowerment (COPE) Program is a Native non-profit organization with formal partnerships with both the Navajo Nation Community Health Representative (CHR) Program and the clinical facilities serving the Navajo Nation. COPE works to better integrate CHRs into the local health care system through training, strengthening care coordination, and a standardized culturally appropriate suite of health promotion materials for CHRs to deliver to high-risk individuals in their homes. The objective of this mixed methods, cross sectional evaluation of a longitudinal cohort study was to explore how the COPE Program has effected CHR teams over the past 6 years. COPE staff surveyed CHRs in concurrent years (2014 and 2015) about their perceptions of and experience working with COPE, including potential effects COPE may have had on communication among patients, CHRs, and hospital-based providers. COPE staff also conducted focus groups with all eight Navajo Nation CHR teams. CHRs and other stakeholders who viewed our results agree that COPE has improved clinic-community linkages, primarily through strengthened collaborations between Public Health Nurses and CHRs, and access to the Electronic Health Records. CHRs perceived that COPE’s programmatic support has strengthened their validity and reputation with providers and clients, and has enhanced their ability to positively effect health outcomes among their clients. CHRs report an improved ability to deliver health coaching to their clients. Survey results show that 80. 2% of CHRs feel strongly positive that COPE trainings are useful, while 44.6% of CHRs felt that communication and teamwork had improved because of COPE. These findings suggest that CHRs have experienced positive benefits from COPE through training. COPE may provide a useful programmatic model on how best to support other Community Health Workers through strengthening clinic-community linkages, standardizing competencies and training support, and structuring home-based interventions for high-risk individuals.

Competency based training in robotic surgery: benchmark scores for virtual reality robotic simulation.

PubMed

Raison, Nicholas; Ahmed, Kamran; Fossati, Nicola; Buffi, Nicolò; Mottrie, Alexandre; Dasgupta, Prokar; Van Der Poel, Henk

2017-05-01

To develop benchmark scores of competency for use within a competency based virtual reality (VR) robotic training curriculum. This longitudinal, observational study analysed results from nine European Association of Urology hands-on-training courses in VR simulation. In all, 223 participants ranging from novice to expert robotic surgeons completed 1565 exercises. Competency was set at 75% of the mean expert score. Benchmark scores for all general performance metrics generated by the simulator were calculated. Assessment exercises were selected by expert consensus and through learning-curve analysis. Three basic skill and two advanced skill exercises were identified. Benchmark scores based on expert performance offered viable targets for novice and intermediate trainees in robotic surgery. Novice participants met the competency standards for most basic skill exercises; however, advanced exercises were significantly more challenging. Intermediate participants performed better across the seven metrics but still did not achieve the benchmark standard in the more difficult exercises. Benchmark scores derived from expert performances offer relevant and challenging scores for trainees to achieve during VR simulation training. Objective feedback allows both participants and trainers to monitor educational progress and ensures that training remains effective. Furthermore, the well-defined goals set through benchmarking offer clear targets for trainees and enable training to move to a more efficient competency based curriculum. © 2016 The Authors BJU International © 2016 BJU International Published by John Wiley & Sons Ltd.

Artificial intelligence techniques applied to the development of a decision–support system for diagnosing celiac disease

PubMed Central

Tenório, Josceli Maria; Hummel, Anderson Diniz; Cohrs, Frederico Molina; Sdepanian, Vera Lucia; Pisa, Ivan Torres; de Fátima Marin, Heimar

2013-01-01

Background Celiac disease (CD) is a difficult-to-diagnose condition because of its multiple clinical presentations and symptoms shared with other diseases. Gold-standard diagnostic confirmation of suspected CD is achieved by biopsying the small intestine. Objective To develop a clinical decision–support system (CDSS) integrated with an automated classifier to recognize CD cases, by selecting from experimental models developed using intelligence artificial techniques. Methods A web-based system was designed for constructing a retrospective database that included 178 clinical cases for training. Tests were run on 270 automated classifiers available in Weka 3.6.1 using five artificial intelligence techniques, namely decision trees, Bayesian inference, k-nearest neighbor algorithm, support vector machines and artificial neural networks. The parameters evaluated were accuracy, sensitivity, specificity and area under the ROC curve (AUC). AUC was used as a criterion for selecting the CDSS algorithm. A testing database was constructed including 38 clinical CD cases for CDSS evaluation. The diagnoses suggested by CDSS were compared with those made by physicians during patient consultations. Results The most accurate method during the training phase was the averaged one-dependence estimator (AODE) algorithm (a Bayesian classifier), which showed accuracy 80.0%, sensitivity 0.78, specificity 0.80 and AUC 0.84. This classifier was integrated into the web-based decision–support system. The gold-standard validation of CDSS achieved accuracy of 84.2% and k = 0.68 (p < 0.0001) with good agreement. The same accuracy was achieved in the comparison between the physician’s diagnostic impression and the gold standard k = 0. 64 (p < 0.0001). There was moderate agreement between the physician’s diagnostic impression and CDSS k = 0.46 (p = 0.0008). Conclusions The study results suggest that CDSS could be used to help in diagnosing CD, since the algorithm tested achieved excellent accuracy in differentiating possible positive from negative CD diagnoses. This study may contribute towards developing of a computer-assisted environment to support CD diagnosis. PMID:21917512

Artificial intelligence techniques applied to the development of a decision-support system for diagnosing celiac disease.

PubMed

Tenório, Josceli Maria; Hummel, Anderson Diniz; Cohrs, Frederico Molina; Sdepanian, Vera Lucia; Pisa, Ivan Torres; de Fátima Marin, Heimar

2011-11-01

Celiac disease (CD) is a difficult-to-diagnose condition because of its multiple clinical presentations and symptoms shared with other diseases. Gold-standard diagnostic confirmation of suspected CD is achieved by biopsying the small intestine. To develop a clinical decision-support system (CDSS) integrated with an automated classifier to recognize CD cases, by selecting from experimental models developed using intelligence artificial techniques. A web-based system was designed for constructing a retrospective database that included 178 clinical cases for training. Tests were run on 270 automated classifiers available in Weka 3.6.1 using five artificial intelligence techniques, namely decision trees, Bayesian inference, k-nearest neighbor algorithm, support vector machines and artificial neural networks. The parameters evaluated were accuracy, sensitivity, specificity and area under the ROC curve (AUC). AUC was used as a criterion for selecting the CDSS algorithm. A testing database was constructed including 38 clinical CD cases for CDSS evaluation. The diagnoses suggested by CDSS were compared with those made by physicians during patient consultations. The most accurate method during the training phase was the averaged one-dependence estimator (AODE) algorithm (a Bayesian classifier), which showed accuracy 80.0%, sensitivity 0.78, specificity 0.80 and AUC 0.84. This classifier was integrated into the web-based decision-support system. The gold-standard validation of CDSS achieved accuracy of 84.2% and k=0.68 (p<0.0001) with good agreement. The same accuracy was achieved in the comparison between the physician's diagnostic impression and the gold standard k=0. 64 (p<0.0001). There was moderate agreement between the physician's diagnostic impression and CDSS k=0.46 (p=0.0008). The study results suggest that CDSS could be used to help in diagnosing CD, since the algorithm tested achieved excellent accuracy in differentiating possible positive from negative CD diagnoses. This study may contribute towards developing of a computer-assisted environment to support CD diagnosis. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

78 FR 979 - Petition for Positive Train Control Safety Plan Approval and System Certification of the...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-01-07

...] Petition for Positive Train Control Safety Plan Approval and System Certification of the Electronic Train... the Federal Railroad Administration (FRA) for Positive Train Control (PTC) Safety Plan (PTCSP...-based train control system safety overlay designed to protect against the consequences of train-to-train...

Refining an Automated Transcranial Doppler System for the Detection of Vasospasm after Traumatic Brain Injury

DTIC Science & Technology

2014-09-01

flow velocity in the MCA and ICA of patients with known vasospasm, as compared to standard TCD run by a trained neurosonographer. Proposed study: Use...the middle cerebral artery (MCA) and internal carotid artery (ICA) of patients with known vasospasm, as compared to standard TCD run by a trained ...Wechsler LR, Toole JF (eds). Transcranial Doppler Ultrasonography. Boston, MA: Butterworth- Heinemann; 1999:109–128. 2. Aaslid R, Nornes H. Musical

Introduction to the Danish Vocational Education and Training System.

ERIC Educational Resources Information Center

Ministry of Education, Copenhagen (Denmark).

Vocational education and training is a concept that covers a sandwich-type course in which school-based education alternates with firm-based training. Broader courses in Denmark include simultaneous work at companies and school training. The advantage to this system is that students do not waste time training for an occupation that they may not…

A patient safety objective structured clinical examination.

PubMed

Singh, Ranjit; Singh, Ashok; Fish, Reva; McLean, Don; Anderson, Diana R; Singh, Gurdev

2009-06-01

There are international calls for improving education for health care workers around certain core competencies, of which patient safety and quality are integral and transcendent parts. Although relevant teaching programs have been developed, little is known about how best to assess their effectiveness. The objective of this work was to develop and implement an objective structured clinical examination (OSCE) to evaluate the impact of a patient safety curriculum. The curriculum was implemented in a family medicine residency program with 47 trainees. Two years after commencing the curriculum, a patient safety OSCE was developed and administered at this program and, for comparison purposes, to incoming residents at the same program and to residents at a neighboring residency program. All 47 residents exposed to the training, all 16 incoming residents, and 10 of 12 residents at the neighboring program participated in the OSCE. In a standardized patient case, error detection and error disclosure skills were better among trained residents. In a chart-based case, trained residents showed better performance in identifying deficiencies in care and described more appropriate means of addressing them. Third year residents exposed to a "Systems Approach" course performed better at system analysis and identifying system-based solutions after the course than before. Results suggest increased systems thinking and inculcation of a culture of safety among residents exposed to a patient safety curriculum. The main weaknesses of the study are its small size and suboptimal design. Much further investigation is needed into the effectiveness of patient safety curricula.

Comparing three pedagogical approaches to psychomotor skills acquisition.

PubMed

Willis, Ross E; Richa, Jacqueline; Oppeltz, Richard; Nguyen, Patrick; Wagner, Kelly; Van Sickle, Kent R; Dent, Daniel L

2012-01-01

We compared traditional pedagogical approaches such as time- and repetition-based methods with proficiency-based training. Laparoscopic novices were assigned randomly to 1 of 3 training conditions. In experiment 1, participants in the time condition practiced for 60 minutes, participants in the repetition condition performed 5 practice trials, and participants in the proficiency condition trained until reaching a predetermined proficiency goal. In experiment 2, practice time and number of trials were equated across conditions. In experiment 1, participants in the proficiency-based training conditions outperformed participants in the other 2 conditions (P < .014); however, these participants trained longer (P < .001) and performed more repetitions (P < .001). In experiment 2, despite training for similar amounts of time and number of repetitions, participants in the proficiency condition outperformed their counterparts (P < .038). In both experiments, the standard deviations for the proficiency condition were smaller than the other conditions. Proficiency-based training results in trainees who perform uniformly and at a higher level than traditional training methodologies. Copyright © 2012 Elsevier Inc. All rights reserved.

The Delphi Method: An Approach for Facilitating Evidence Based Practice in Athletic Training

ERIC Educational Resources Information Center

Sandrey, Michelle A.; Bulger, Sean M.

2008-01-01

Objective: The growing importance of evidence based practice in athletic training is necessitating academics and clinicians to be able to make judgments about the quality or lack of the body of research evidence and peer-reviewed standards pertaining to clinical questions. To assist in the judgment process, consensus methods, namely brainstorming,…

Computer-Based Counselor-in-Training Supervision: Ethical and Practical Implications for Counselor Educators and Supervisors

ERIC Educational Resources Information Center

Vaccaro, Nicole; Lambie, Glenn W.

2007-01-01

Computer-based clinical supervision of counselors-in-training is becoming more prevalent (M. Reisch & L. Jarman-Rohde, 2000); however, its use is still in its infancy, and ethical standards have not been established regarding its practice. There exists a dearth of literature focusing on the ethical practice and development of supervisees when…

Competency-Based Training: An Assessment of Its Strengths and Weaknesses by New South Wales Vocational Teachers.

ERIC Educational Resources Information Center

Cornford, Ian R.

1997-01-01

A survey of 72 New South Wales vocational teachers revealed that competency-based training has created perceived pressures to pass students, is difficult to implement with limited resources, encourages modularization, and is hampered by unsatisfactory assessment and standards. Over 61% of the teachers felt that it has hindered or severely hindered…

Mark 4A project training evaluation

NASA Technical Reports Server (NTRS)

Stephenson, S. N.

1985-01-01

A participant evaluation of a Deep Space Network (DSN) is described. The Mark IVA project is an implementation to upgrade the tracking and data acquisition systems of the dSN. Approximately six hundred DSN operations and engineering maintenance personnel were surveyed. The survey obtained a convenience sample including trained people within the population in order to learn what training had taken place and to what effect. The survey questionnaire used modifications of standard rating scales to evaluate over one hundred items in four training dimensions. The scope of the evaluation included Mark IVA vendor training, a systems familiarization training seminar, engineering training classes, a on-the-job training. Measures of central tendency were made from participant rating responses. Chi square tests of statistical significance were performed on the data. The evaluation results indicated that the effects of different Mark INA training methods could be measured according to certain ratings of technical training effectiveness, and that the Mark IVA technical training has exhibited positive effects on the abilities of DSN personnel to operate and maintain new Mark IVA equipment systems.

Laparoscopic surgical box model training for surgical trainees with limited prior laparoscopic experience.

PubMed

Gurusamy, Kurinchi Selvan; Nagendran, Myura; Toon, Clare D; Davidson, Brian R

2014-03-01

Surgical training has traditionally been one of apprenticeship, where the surgical trainee learns to perform surgery under the supervision of a trained surgeon. This is time consuming, costly, and of variable effectiveness. Training using a box model physical simulator is an option to supplement standard training. However, the value of this modality on trainees with limited prior laparoscopic experience is unknown. To compare the benefits and harms of box model training for surgical trainees with limited prior laparoscopic experience versus standard surgical training or supplementary animal model training. We searched the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, EMBASE, and Science Citation Index Expanded to May 2013. We planned to include all randomised clinical trials comparing box model trainers versus other forms of training including standard laparoscopic training and supplementary animal model training in surgical trainees with limited prior laparoscopic experience. We also planned to include trials comparing different methods of box model training. Two authors independently identified trials and collected data. We analysed the data with both the fixed-effect and the random-effects models using Review Manager 5. For each outcome, we calculated the risk ratio (RR), mean difference (MD), or standardised mean difference (SMD) with 95% confidence intervals (CI) based on intention-to-treat analysis whenever possible. We identified eight trials that met the inclusion criteria. One trial including 17 surgical trainees did not contribute to the meta-analysis. We included seven trials (249 surgical trainees belonging to various postgraduate years ranging from year one to four) in which the participants were randomised to supplementary box model training (122 trainees) versus standard training (127 trainees). Only one trial (50 trainees) was at low risk of bias. The box trainers used in all the seven trials were video trainers. Six trials were conducted in USA and one trial in Canada. The surgeries in which the final assessments were made included laparoscopic total extraperitoneal hernia repairs, laparoscopic cholecystectomy, laparoscopic tubal ligation, laparoscopic partial salpingectomy, and laparoscopic bilateral mid-segment salpingectomy. The final assessments were made on a single operative procedure.There were no deaths in three trials (0/82 (0%) supplementary box model training versus 0/86 (0%) standard training; RR not estimable; very low quality evidence). The other trials did not report mortality. The estimated effect on serious adverse events was compatible with benefit and harm (three trials; 168 patients; 0/82 (0%) supplementary box model training versus 1/86 (1.1%) standard training; RR 0.36; 95% CI 0.02 to 8.43; very low quality evidence). None of the trials reported patient quality of life. The operating time was significantly shorter in the supplementary box model training group versus the standard training group (1 trial; 50 patients; MD -6.50 minutes; 95% CI -10.85 to -2.15). The proportion of patients who were discharged as day-surgery was significantly higher in the supplementary box model training group versus the standard training group (1 trial; 50 patients; 24/24 (100%) supplementary box model training versus 15/26 (57.7%) standard training; RR 1.71; 95% CI 1.23 to 2.37). None of the trials reported trainee satisfaction. The operating performance was significantly better in the supplementary box model training group versus the standard training group (seven trials; 249 trainees; SMD 0.84; 95% CI 0.57 to 1.10).None of the trials compared box model training versus animal model training or versus different methods of box model training. There is insufficient evidence to determine whether laparoscopic box model training reduces mortality or morbidity. There is very low quality evidence that it improves technical skills compared with standard surgical training in trainees with limited previous laparoscopic experience. It may also decrease operating time and increase the proportion of patients who were discharged as day-surgery in the first total extraperitoneal hernia repair after box model training. However, the duration of the benefit of box model training is unknown. Further well-designed trials of low risk of bias and random errors are necessary. Such trials should assess the long-term impact of box model training on clinical outcomes and compare box training with other forms of training.

Refrigeration and Air Conditioning Mechanic: Apprenticeship Course Outline. Apprenticeship and Industry Training. 1411.2

ERIC Educational Resources Information Center

Alberta Advanced Education and Technology, 2011

2011-01-01

The graduate of the Refrigeration and Air Conditioning Mechanic apprenticeship training is a journeyman who will: (1) supervise, train and coach apprentices; (2) use and maintain hand and power tools to the standards of competency and safety required in the trade; (3) have a thorough knowledge of the principle components of refrigeration systems,…

A Lack of Continuity in Education, Training, and Practice Violates the "Do No Harm" Principle.

PubMed

Englander, Robert; Carraccio, Carol

2018-03-01

The paradigm shift to competency-based medical education (CBME) is under way, but incomplete implementation is blunting the potential impact on learning and patient outcomes. The fundamental principles of CBME call for standardizing outcomes addressing population health needs, then allowing time-variable progression to achieving them. Operationalizing CBME principles requires continuity within and across phases of the education, training, and practice continuum. However, the piecemeal origin of the phases of the "continuum" has resulted in a sequence of undergraduate to graduate medical education to practice that may be continuous temporally but bears none of the integration of a true continuum.With these timed interruptions during phase transitions, learning is not reinforced because of a failure to integrate experiences. Brief block rotations for learners and ever-shorter supervisory assignments for faculty preclude the development of relationships. Without these relationships, feedback falls on deaf ears. Block rotations also disrupt learners' relationships with patients. The harms resulting from such a system include decreases in patient satisfaction with their care and learner satisfaction with their work. Learners in this block system also demonstrate an erosion of empathy compared with those in innovative longitudinal training models. In addition, higher patient mortality during intern transitions has been demonstrated.The current medical education system is violating the first principle of medicine: "Do no harm." Full implementation of competency-based, time-variable education and training, with fixed outcomes aligned with population health needs, continuity in learning and relationships, and support from a developmental program of assessment, holds great potential to stop this harm.

Dataset variability leverages white-matter lesion segmentation performance with convolutional neural network

NASA Astrophysics Data System (ADS)

Ravnik, Domen; Jerman, Tim; Pernuš, Franjo; Likar, Boštjan; Å piclin, Žiga

2018-03-01

Performance of a convolutional neural network (CNN) based white-matter lesion segmentation in magnetic resonance (MR) brain images was evaluated under various conditions involving different levels of image preprocessing and augmentation applied and different compositions of the training dataset. On images of sixty multiple sclerosis patients, half acquired on one and half on another scanner of different vendor, we first created a highly accurate multi-rater consensus based lesion segmentations, which were used in several experiments to evaluate the CNN segmentation result. First, the CNN was trained and tested without preprocessing the images and by using various combinations of preprocessing techniques, namely histogram-based intensity standardization, normalization by whitening, and train dataset augmentation by flipping the images across the midsagittal plane. Then, the CNN was trained and tested on images of the same, different or interleaved scanner datasets using a cross-validation approach. The results indicate that image preprocessing has little impact on performance in a same-scanner situation, while between-scanner performance benefits most from intensity standardization and normalization, but also further by incorporating heterogeneous multi-scanner datasets in the training phase. Under such conditions the between-scanner performance of the CNN approaches that of the ideal situation, when the CNN is trained and tested on the same scanner dataset.

[An analysis of residents' self-evaluation and faculty-evaluation in internal medicine standardized residency training program using Milestones evaluation system].

PubMed

Zhang, Y; Chu, X T; Zeng, X J; Li, H; Zhang, F C; Zhang, S Y; Shen, T

2018-06-01

Objective: To assess the value of internal medicine residency training program at Peking Union Medical College Hospital (PUMCH), and the feasibility of applying revised Milestones evaluation system. Methods: Postgraduate-year-one to four (PGY-1 to PGY-4) residents in PUMCH finished the revised Milestones evaluation scales in September 2017. Residents' self-evaluation and faculty-evaluation scores were calculated. Statistical analysis was conducted on the data. Results: A total of 207 residents were enrolled in this cross-sectional study. Both self and faculty scores showed an increasing trend in senior residents. PGY-1 residents were assessed during their first month of residency with scores of 4 points or higher, suggesting that residents have a high starting level. More strikingly, the mean score in PGY-4 was 7 points or higher, proving the career development of residency training program. There was no statistically significant difference between total self- and faculty-evaluation scores. Evaluation scores of learning ability and communication ability were lower in faculty group ( t =-2.627, -4.279, all P <0.05). The scores in graduate students were lower than those in standardized training residents. Conclusions: The goal of national standardized residency training is to improve the quality of healthcare and residents' career development. The evaluation results would guide curriculum design and emphasize the importance and necessity of multi-level teaching. Self-evaluation contributes to the understanding of training objectives and personal cognition.

Efficacy of standardized training on a virtual reality simulator to advance knee and shoulder arthroscopic motor skills.

PubMed

Rahm, Stefan; Wieser, Karl; Bauer, David E; Waibel, Felix Wa; Meyer, Dominik C; Gerber, Christian; Fucentese, Sandro F

2018-05-16

Most studies demonstrated, that training on a virtual reality based arthroscopy simulator leads to an improvement of technical skills in orthopaedic surgery. However, how long and what kind of training is optimal for young residents is unknown. In this study we tested the efficacy of a standardized, competency based training protocol on a validated virtual reality based knee- and shoulder arthroscopy simulator. Twenty residents and five experts in arthroscopy were included. All participants performed a test including knee -and shoulder arthroscopy tasks on a virtual reality knee- and shoulder arthroscopy simulator. The residents had to complete a competency based training program. Thereafter, the previously completed test was retaken. We evaluated the metric data of the simulator using a z-score and the Arthroscopic Surgery Skill Evaluation Tool (ASSET) to assess training effects in residents and performance levels in experts. The residents significantly improved from pre- to post training in the overall z-score: - 9.82 (range, - 20.35 to - 1.64) to - 2.61 (range, - 6.25 to 1.5); p < 0.001. The overall ASSET score improved from 55 (27 to 84) percent to 75 (48 to 92) percent; p < 0.001. The experts, however, achieved a significantly higher z-score in the shoulder tasks (p < 0.001 and a statistically insignificantly higher z-score in the knee tasks with a p = 0.921. The experts mean overall ASSET score (knee and shoulder) was significantly higher in the therapeutic tasks (p < 0.001) compared to the residents post training result. The use of a competency based simulator training with this specific device for 3-5 h is an effective tool to advance basic arthroscopic skills of resident in training from 0 to 5 years based on simulator measures and simulator based ASSET testing. Therefore, we conclude that this sort of training method appears useful to learn the handling of the camera, basic anatomy and the triangulation with instruments.

Easy and effective--web-based information systems designed and maintained by physicians: experience with two gynecological projects.

PubMed

Kupka, M S; Dorn, C; Richter, O; van der Ven, H; Baur, M

2003-08-01

It is well established that medical information sources develop continuously from printed media to digital online sources. To demonstrate effectiveness and feasibility of decentralized performed web-based information sources for health professionals, two projects are described. The information platform of the German Working Group for Information Technologies in Gynecology and Obstetrics (AIG) and the information source concerning the German Registry for in vitro fertilization (DIR) were implemented using ordinary software and standard computer equipment. Only minimal resources and training were necessary to perform safe and reliable web-based information sources with a high correlation of effectiveness in costs and time exposure.

Core competencies in clinical neuropsychology training across the world.

PubMed

Hessen, Erik; Hokkanen, Laura; Ponsford, Jennie; van Zandvoort, Martine; Watts, Ann; Evans, Jonathan; Haaland, Kathleen Y

2018-05-01

This work aimed to review main competency requirements from training models in countries with well-established specialties in clinical neuropsychology and to extract core competencies that likely will apply to clinical neuropsychologists regardless of regional and cultural context. We reviewed standards for post-graduate training in clinical neuropsychology from countries in Europe, Australia, and North America based on existing literature, presentations at international conferences, and from description of the training models from national psychological or neuropsychological associations. Despite differences, the reviewed models share similar core competencies considered necessary for a specialty in clinical neuropsychology: (1) In-depth knowledge of general psychology including clinical psychology (post-graduate level), ethical, and legal standards. (2) Expert knowledge about clinically relevant brain-behavioral relationships. (3) Comprehensive knowledge about, and skills in, related clinical disciplines. (4) In-depth knowledge about and skills in neuropsychological assessment, including decision-making and diagnostic competency according to current classification of diseases. (5) Competencies in the area of diversity and culture in relation to clinical neuropsychology. (6) Communication competency of neuropsychological findings and test results to relevant and diverse audiences. (7) Knowledge about and skills in psychological and neuropsychological intervention, including treatment and rehabilitation. All the models have undergone years of development in accordance with requirements of national health care systems in different parts of the world. Despite differences, the common core competency requirements across different regions of the world suggest generalizability of these competencies. We hope this summary can be useful as countries with less established neuropsychology training programs develop their models.

Effects of Rifle Handling, Target Acquisition, and Trigger Control on Simulated Shooting Performance

DTIC Science & Technology

2014-05-06

qualification task, and covers all of the training requirements listed in the Soldier’s Manual of Common Tasks: Warrior Skills Level 1 handbook...allow for more direct and standardized training based on common Soldier errors. If discernible patterns in these core elements of marksmanship were...more than 50 percent of variance in marksmanship performance on a standard EST weapons qualification task for participants whose 3 Snellen acuity

Home-based, early intervention with mechatronic toys for preterm infants at risk of neurodevelopmental disorders (CARETOY): a RCT protocol.

PubMed

Sgandurra, Giuseppina; Bartalena, Laura; Cioni, Giovanni; Greisen, Gorm; Herskind, Anna; Inguaggiato, Emanuela; Lorentzen, Jakob; Nielsen, Jens Bo; Sicola, Elisa

2014-10-15

Preterm infants are at risk for neurodevelopmental disorders, including motor, cognitive or behavioural problems, which may potentially be modified by early intervention. The EU CareToy Project Consortium (http://www.caretoy.eu) has developed a new modular system for intensive, individualized, home-based and family-centred early intervention, managed remotely by rehabilitation staff. A randomised controlled trial (RCT) has been designed to evaluate the efficacy of CareToy training in a first sample of low-risk preterm infants. The trial, randomised, multi-center, evaluator-blinded, parallel group controlled, is designed according to CONSORT Statement. Eligible subjects are infants born preterm without major complications, aged 3-9 months of corrected age with specific gross-motor abilities defined by Ages & Stages Questionnaire scores. Recruited infants, whose parents will sign a written informed consent for participation, will be randomized in CareToy training and control groups at baseline (T0). CareToy group will perform four weeks of personalized activities with the CareToy system, customized by the rehabilitation staff. The control group will continue standard care. Infant Motor Profile Scale is the primary outcome measure and a total sample size of 40 infants has been established. Bayley-Cognitive subscale, Alberta Infants Motor Scale and Teller Acuity Cards are secondary outcome measures. All measurements will be performed at T0 and at the end of training/control period (T1). For ethical reasons, after this first phase infants enrolled in the control group will perform the CareToy training, while the training group will continue standard care. At the end of open phase (T2) all infants will be assessed as at T1. Further assessment will be performed at 18 months corrected age (T3) to evaluate the long-term effects on neurodevelopmental outcome. Caregivers and rehabilitation staff will not be blinded whereas all the clinical assessments will be performed, videotaped and scored by blind assessors. The trial is ongoing and it is expected to be completed by April 2015. This paper describes RCT methodology to evaluate CareToy as a new tool for early intervention in preterm infants, first contribution to test this new type of system. It presents background, hypotheses, outcome measures and trial methodology. ClinicalTrials.gov: NCT01990183. EU grant ICT-2011.5.1-287932.

Development of Standardized Clinical Training Cases for Diagnosis of Sexual Abuse using a Secure Telehealth Application

ERIC Educational Resources Information Center

Frasier, Lori D.; Thraen, Ioana; Kaplan, Rich; Goede, Patricia

2012-01-01

Objectives: The training of physicians, nurse examiners, social workers and other health professional on the evidentiary findings of sexual abuse in children is challenging. Our objective was to develop peer reviewed training cases for medical examiners of child sexual abuse, using a secure web based telehealth application (TeleCAM). Methods:…

Standardization of computer-assisted semen analysis using an e-learning application.

PubMed

Ehlers, J; Behr, M; Bollwein, H; Beyerbach, M; Waberski, D

2011-08-01

Computer-assisted semen analysis (CASA) is primarily used to obtain accurate and objective kinetic sperm measurements. Additionally, AI centers use computer-assessed sperm concentration in the sample as a basis for calculating the number of insemination doses available from a given ejaculate. The reliability of data is often limited and results can vary even when the same CASA systems with identical settings are used. The objective of the present study was to develop a computer-based training module for standardized measurements with a CASA system and to evaluate its training effect on the quality of the assessment of sperm motility and concentration. A digital versatile disc (DVD) has been produced showing the standardization of sample preparation and analysis with the CASA system SpermVision™ version 3.0 (Minitube, Verona, WI, USA) in words, pictures, and videos, as well as the most probable sources of error. Eight test persons educated in spermatology, but with different levels of experience with the CASA system, prepared and assessed 10 aliquots from one prediluted bull ejaculate using the same CASA system and laboratory equipment before and after electronic learning (e-learning). After using the e-learning application, the coefficient of variation was reduced on average for the sperm concentration from 26.1% to 11.3% (P ≤ 0.01), and for motility from 5.8% to 3.1% (P ≤ 0.05). For five test persons, the difference in the coefficient of variation before and after use of the e-learning application was significant (P ≤ 0.05). Individual deviations of means from the group mean before e-learning were reduced compared with individual deviations from the group mean after e-learning. According to a survey, the e-learning application was highly accepted by users. In conclusion, e-learning presents an effective, efficient, and accepted tool for improvement of the precision of CASA measurements. This study provides a model for the standardization of other laboratory procedures using e-learning. Copyright © 2011 Elsevier Inc. All rights reserved.

Diversity and cultural competence training in health care organizations: hallmarks of success.

PubMed

Curtis, Ellen Foster; Dreachslin, Janice L; Sinioris, Marie

2007-01-01

The authors reviewed recent literature on diversity training interventions and identified effective practices for health care organizations. Self-reported satisfaction was especially likely to be found as a result of training, whereas attitude change measured by standardized instruments was mixed. Although those responsible for diversity training in the workplace agree that behavioral change is key, awareness building and associated attitude change remain the focus of most diversity training in the workplace. Consequently, the authors recommend a systems approach to diversity training interventions wherein training is a key component of a health care organization's strategic approach to organizational performance, and diversity training is linked to the organizations' strategic goals for improved quality of care. The systems approach requires these steps: determine diversity and cultural competence goals in the context of strategy, measure current performance against needs, design training to address the gap, implement the training, assess training effectiveness, and strive for continuous improvement. Higher level evaluations measuring whether employees have transferred learning from training to their jobs are paramount to the systems approach to diversity training interventions. Measuring other positive changes in a "return on investment" format can be used to convince stakeholders of training's value.

Haptic interface of web-based training system for interventional radiology procedures

NASA Astrophysics Data System (ADS)

Ma, Xin; Lu, Yiping; Loe, KiaFock; Nowinski, Wieslaw L.

2004-05-01

The existing web-based medical training systems and surgical simulators can provide affordable and accessible medical training curriculum, but they seldom offer the trainee realistic and affordable haptic feedback. Therefore, they cannot offer the trainee a suitable practicing environment. In this paper, a haptic solution for interventional radiology (IR) procedures is proposed. System architecture of a web-based training system for IR procedures is briefly presented first. Then, the mechanical structure, the working principle and the application of a haptic device are discussed in detail. The haptic device works as an interface between the training environment and the trainees and is placed at the end user side. With the system, the user can be trained on the interventional radiology procedures - navigating catheters, inflating balloons, deploying coils and placing stents on the web and get surgical haptic feedback in real time.

V-TECS Guide for Automobile Air Conditioning and Electrical System Technician.

ERIC Educational Resources Information Center

Meyer, Calvin F.; Benson, Robert T.

This curriculum guide provides an outline for an eight-unit course to train automobile air conditioning and electrical system technicians. Each unit focuses on a duty that is composed of a number of performance objectives. For each objective, these materials are provided: a task, a standard of performance of task, source of standard, conditions…

Decaying relevance of clinical data towards future decisions in data-driven inpatient clinical order sets.

PubMed

Chen, Jonathan H; Alagappan, Muthuraman; Goldstein, Mary K; Asch, Steven M; Altman, Russ B

2017-06-01

Determine how varying longitudinal historical training data can impact prediction of future clinical decisions. Estimate the "decay rate" of clinical data source relevance. We trained a clinical order recommender system, analogous to Netflix or Amazon's "Customers who bought A also bought B..." product recommenders, based on a tertiary academic hospital's structured electronic health record data. We used this system to predict future (2013) admission orders based on different subsets of historical training data (2009 through 2012), relative to existing human-authored order sets. Predicting future (2013) inpatient orders is more accurate with models trained on just one month of recent (2012) data than with 12 months of older (2009) data (ROC AUC 0.91 vs. 0.88, precision 27% vs. 22%, recall 52% vs. 43%, all P<10 -10 ). Algorithmically learned models from even the older (2009) data was still more effective than existing human-authored order sets (ROC AUC 0.81, precision 16% recall 35%). Training with more longitudinal data (2009-2012) was no better than using only the most recent (2012) data, unless applying a decaying weighting scheme with a "half-life" of data relevance about 4 months. Clinical practice patterns (automatically) learned from electronic health record data can vary substantially across years. Gold standards for clinical decision support are elusive moving targets, reinforcing the need for automated methods that can adapt to evolving information. Prioritizing small amounts of recent data is more effective than using larger amounts of older data towards future clinical predictions. Copyright © 2017 The Authors. Published by Elsevier B.V. All rights reserved.

Progress in the blood supply of Afghanistan.

PubMed

Riley, William J; McCullough, Terri Konstenius; Rhamani, Ahmad Masoud; McCullough, Jeffrey

2017-07-01

The blood supply system in Afghanistan was badly damaged by years of conflict. In 2009, the Afghanistan National Blood Safety and Transfusion Service (ANBSTS) was established. For 6 years, we collaborated to assist with policy and infrastructure development; blood bank operations; blood collection, testing, and component production; transfusion practices; and training of technicians, nurses, midwives, and physicians. Policies were established, infrastructure was strengthened, and capable staff was acquired and trained. Standard operating procedures were developed, testing was improved, and quality systems were established. Thirty trainings were held for blood center staff. Four additional formal trainings were held for 39 physicians, 36 nurses and/or midwives, and 38 laboratory technicians. During 5 years of this project, blood collection increased by 40%. The ANBSTS has made impressive progress developing infrastructure, personnel, procedures, quality systems, and training programs and increasing blood collection. Knowledge of transfusion medicine was improved through structured training. © 2017 AABB.

Congenital rubella syndrome surveillance in Honduras.

PubMed

Molina, Ida Berenice; Mendoza, Lourdes Otilia; Palma, María Aparicia

2011-09-01

Congenital rubella syndrome (CRS) surveillance was established in Honduras to determine the scope of the problem and assess the impact of vaccination. Implementation of the surveillance system required the drafting of national CRS epidemiological surveillance guidelines, the development of a laboratory diagnostic method, and training of physicians, nurses, and microbiologists in the Honduran hospital network and social security system on CRS surveillance guidelines. Honduras' experience with the surveillance of other vaccine-preventable diseases facilitated the implementation of hospital-based CRS surveillance. The surveillance system operates in 23 of the 25 public hospitals that offer services to children and at 2 social security hospitals; the private sector has not been integrated into this system. Clinical and technical staff, including representatives from various disciplines such as pediatrics, neonatology, general medicine, epidemiology, nursing, and microbiology, participate in the hospital network, as well as follow up on cases in accordance with the standardized guidelines, depending on their areas of expertise. Implementation of the CRS surveillance system requires technical guidelines, laboratory diagnostic capacity, and trained multidisciplinary human resources for its systematization and operation.

A New Perspective for the Training Assessment: Machine Learning-Based Neurometric for Augmented User's Evaluation

PubMed Central

Borghini, Gianluca; Aricò, Pietro; Di Flumeri, Gianluca; Sciaraffa, Nicolina; Colosimo, Alfredo; Herrero, Maria-Trinidad; Bezerianos, Anastasios; Thakor, Nitish V.; Babiloni, Fabio

2017-01-01

Inappropriate training assessment might have either high social costs and economic impacts, especially in high risks categories, such as Pilots, Air Traffic Controllers, or Surgeons. One of the current limitations of the standard training assessment procedures is the lack of information about the amount of cognitive resources requested by the user for the correct execution of the proposed task. In fact, even if the task is accomplished achieving the maximum performance, by the standard training assessment methods, it would not be possible to gather and evaluate information about cognitive resources available for dealing with unexpected events or emergency conditions. Therefore, a metric based on the brain activity (neurometric) able to provide the Instructor such a kind of information should be very important. As a first step in this direction, the Electroencephalogram (EEG) and the performance of 10 participants were collected along a training period of 3 weeks, while learning the execution of a new task. Specific indexes have been estimated from the behavioral and EEG signal to objectively assess the users' training progress. Furthermore, we proposed a neurometric based on a machine learning algorithm to quantify the user's training level within each session by considering the level of task execution, and both the behavioral and cognitive stabilities between consecutive sessions. The results demonstrated that the proposed methodology and neurometric could quantify and track the users' progresses, and provide the Instructor information for a more objective evaluation and better tailoring of training programs. PMID:28659751

A New Perspective for the Training Assessment: Machine Learning-Based Neurometric for Augmented User's Evaluation.

PubMed

Borghini, Gianluca; Aricò, Pietro; Di Flumeri, Gianluca; Sciaraffa, Nicolina; Colosimo, Alfredo; Herrero, Maria-Trinidad; Bezerianos, Anastasios; Thakor, Nitish V; Babiloni, Fabio

2017-01-01

Inappropriate training assessment might have either high social costs and economic impacts, especially in high risks categories, such as Pilots, Air Traffic Controllers, or Surgeons. One of the current limitations of the standard training assessment procedures is the lack of information about the amount of cognitive resources requested by the user for the correct execution of the proposed task. In fact, even if the task is accomplished achieving the maximum performance, by the standard training assessment methods, it would not be possible to gather and evaluate information about cognitive resources available for dealing with unexpected events or emergency conditions. Therefore, a metric based on the brain activity ( neurometric ) able to provide the Instructor such a kind of information should be very important. As a first step in this direction, the Electroencephalogram (EEG) and the performance of 10 participants were collected along a training period of 3 weeks, while learning the execution of a new task. Specific indexes have been estimated from the behavioral and EEG signal to objectively assess the users' training progress. Furthermore, we proposed a neurometric based on a machine learning algorithm to quantify the user's training level within each session by considering the level of task execution, and both the behavioral and cognitive stabilities between consecutive sessions. The results demonstrated that the proposed methodology and neurometric could quantify and track the users' progresses, and provide the Instructor information for a more objective evaluation and better tailoring of training programs.

Evaluation of a computer-based educational intervention to improve medical teamwork and performance during simulated patient resuscitations.

PubMed

Fernandez, Rosemarie; Pearce, Marina; Grand, James A; Rench, Tara A; Jones, Kerin A; Chao, Georgia T; Kozlowski, Steve W J

2013-11-01

To determine the impact of a low-resource-demand, easily disseminated computer-based teamwork process training intervention on teamwork behaviors and patient care performance in code teams. A randomized comparison trial of computer-based teamwork training versus placebo training was conducted from August 2010 through March 2011. This study was conducted at the simulation suite within the Kado Family Clinical Skills Center, Wayne State University School of Medicine. Participants (n = 231) were fourth-year medical students and first-, second-, and third-year emergency medicine residents at Wayne State University. Each participant was assigned to a team of four to six members (nteams = 45). Teams were randomly assigned to receive either a 25-minute computer-based training module targeting appropriate resuscitation teamwork behaviors or a placebo training module. Teamwork behaviors and patient care behaviors were video recorded during high-fidelity simulated patient resuscitations and coded by trained raters blinded to condition assignment and study hypotheses. Teamwork behavior items (e.g., "chest radiograph findings communicated to team" and "team member assists with intubation preparation") were standardized before combining to create overall teamwork scores. Similarly, patient care items ("chest radiograph correctly interpreted"; "time to start of compressions") were standardized before combining to create overall patient care scores. Subject matter expert reviews and pilot testing of scenario content, teamwork items, and patient care items provided evidence of content validity. When controlling for team members' medically relevant experience, teams in the training condition demonstrated better teamwork (F [1, 42] = 4.81, p < 0.05; ηp = 10%) and patient care (F [1, 42] = 4.66, p < 0.05; ηp = 10%) than did teams in the placebo condition. Computer-based team training positively impacts teamwork and patient care during simulated patient resuscitations. This low-resource team training intervention may help to address the dissemination and sustainability issues associated with larger, more costly team training programs.

Solving the master equation without kinetic Monte Carlo: Tensor train approximations for a CO oxidation model

DOE Office of Scientific and Technical Information (OSTI.GOV)

Gelß, Patrick, E-mail: p.gelss@fu-berlin.de; Matera, Sebastian, E-mail: matera@math.fu-berlin.de; Schütte, Christof, E-mail: schuette@mi.fu-berlin.de

2016-06-01

In multiscale modeling of heterogeneous catalytic processes, one crucial point is the solution of a Markovian master equation describing the stochastic reaction kinetics. Usually, this is too high-dimensional to be solved with standard numerical techniques and one has to rely on sampling approaches based on the kinetic Monte Carlo method. In this study we break the curse of dimensionality for the direct solution of the Markovian master equation by exploiting the Tensor Train Format for this purpose. The performance of the approach is demonstrated on a first principles based, reduced model for the CO oxidation on the RuO{sub 2}(110) surface.more » We investigate the complexity for increasing system size and for various reaction conditions. The advantage over the stochastic simulation approach is illustrated by a problem with increased stiffness.« less

Virtual reality simulation training of mastoidectomy - studies on novice performance.

PubMed

Andersen, Steven Arild Wuyts

2016-08-01

Virtual reality (VR) simulation-based training is increasingly used in surgical technical skills training including in temporal bone surgery. The potential of VR simulation in enabling high-quality surgical training is great and VR simulation allows high-stakes and complex procedures such as mastoidectomy to be trained repeatedly, independent of patients and surgical tutors, outside traditional learning environments such as the OR or the temporal bone lab, and with fewer of the constraints of traditional training. This thesis aims to increase the evidence-base of VR simulation training of mastoidectomy and, by studying the final-product performances of novices, investigates the transfer of skills to the current gold-standard training modality of cadaveric dissection, the effect of different practice conditions and simulator-integrated tutoring on performance and retention of skills, and the role of directed, self-regulated learning. Technical skills in mastoidectomy were transferable from the VR simulation environment to cadaveric dissection with significant improvement in performance after directed, self-regulated training in the VR temporal bone simulator. Distributed practice led to a better learning outcome and more consolidated skills than massed practice and also resulted in a more consistent performance after three months of non-practice. Simulator-integrated tutoring accelerated the initial learning curve but also caused over-reliance on tutoring, which resulted in a drop in performance when the simulator-integrated tutor-function was discontinued. The learning curves were highly individual but often plateaued early and at an inadequate level, which related to issues concerning both the procedure and the VR simulator, over-reliance on the tutor function and poor self-assessment skills. Future simulator-integrated automated assessment could potentially resolve some of these issues and provide trainees with both feedback during the procedure and immediate assessment following each procedure. Standard setting by establishing a proficiency level that can be used for mastery learning with deliberate practice could also further sophisticate directed, self-regulated learning in VR simulation-based training. VR simulation-based training should be embedded in a systematic and competency-based training curriculum for high-quality surgical skills training, ultimately leading to improved safety and patient care.

[Improvement of higher medical education via the system of quality specialist training].

PubMed

Artiukhov, I P; Samotesov, P A; Nikulina, S Iu; Salmina, A B; Petrova, M M; Gritsan, A I; Rossiev, D A

2009-01-01

Development of the system of management of quality specialist training in the Kraysnoysrsk State Medical Academy allowed to optimize administration and academic process, create conditions for introduction of innovative technologies in educational, research, and clinico-diagnostic activities for the purpose of their standardization and realization of managerial decisions. The new system promotes organization of administrative and educational work of the Academy in line with leading trends of regional development, stimulates creativity and strategic planning.

[Space flight/bedrest immobilization and bone. Development a devise to maintain the skeletal muscles in space].

PubMed

Shiba, Naoto; Matsuse, Hiroo; Nago, Takeshi; Masayuki, Omoto; Kawaguchi, Takumi; Tagawa, Yoshihiko

2012-12-01

We have developed a "hybrid training system" (HTS) that is designed to maintain the musculoskeletal system of astronauts by using an electrically stimulated antagonist to resist the volitional contraction of agonist muscles in weightlessness. In other words, electrical stimulation generates a resistive force instead of gravity. HTS will become a useful back-up for the standard training device in the International Space Station, or a useful training device in the small space ship for the exploration of the Moon and Mars.

CRM Assessment: Determining the Generalization of Rater Calibration Training. Summary of Research Report: Gold Standards Training

NASA Technical Reports Server (NTRS)

Baker, David P.

2002-01-01

The extent to which pilot instructors are trained to assess crew resource management (CRM) skills accurately during Line-Oriented Flight Training (LOFT) and Line Operational Evaluation (LOE) scenarios is critical. Pilot instructors must make accurate performance ratings to ensure that proper feedback is provided to flight crews and appropriate decisions are made regarding certification to fly the line. Furthermore, the Federal Aviation Administration's (FAA) Advanced Qualification Program (AQP) requires that instructors be trained explicitly to evaluate both technical and CRM performance (i.e., rater training) and also requires that proficiency and standardization of instructors be verified periodically. To address the critical need for effective pilot instructor training, the American Institutes for Research (AIR) reviewed the relevant research on rater training and, based on "best practices" from this research, developed a new strategy for training pilot instructors to assess crew performance. In addition, we explored new statistical techniques for assessing the effectiveness of pilot instructor training. The results of our research are briefly summarized below. This summary is followed by abstracts of articles and book chapters published under this grant.

Use of virtual reality in rehabilitation of movement in children with hemiplegia--a multiple case study evaluation.

PubMed

Green, Dido; Wilson, Peter H

2012-01-01

To evaluate the feasibility and therapeutic effect of engaging children of differing neuromotor and cognitive ability in a virtual reality (VR) tabletop workspace designed to improve upper-limb function. Single-subject experimental design with multiple baselines was employed. Four children with hemiplegia participated in VR-based training between nine and 19, 30-minute sessions, over three-four weeks. Outcomes were assessed from the perspective of the International Classification of Functioning, Disability and Health; considering body function, activity performance and participation. Upper-limb performance was assessed using system-measured variables (speed, trajectory and accuracy) and standardized tests. Trend analyses were employed to determine trends on system variables between baseline phase and treatment phases. Standardised measures were compared between pre- and post-training. Two children made progress across system variables with some translation to daily activities. Performance of the other two children was more variable, however, they engaged positively with the system by the end of the treatment phase. The VR (RE-ACTION) system shows promise as an engaging rehabilitation tool to improve upper-limb function of children with hemiplegia, across ability levels. Trade-offs between kinematic variables should be considered when measuring improvements in movement skill. Larger trials are warranted to evaluate effects of augmented feedback, intensity and duration of training, and interface type to optimise the system's effectiveness.

Employing Virtual Humans for Education and Training in X3D/VRML Worlds

ERIC Educational Resources Information Center

Ieronutti, Lucio; Chittaro, Luca

2007-01-01

Web-based education and training provides a new paradigm for imparting knowledge; students can access the learning material anytime by operating remotely from any location. Web3D open standards, such as X3D and VRML, support Web-based delivery of Educational Virtual Environments (EVEs). EVEs have a great potential for learning and training…

Introducing criteria based audit into Ugandan maternity units.

PubMed

Weeks, A D; Alia, G; Ononge, S; Mutungi, A; Otolorin, E O; Mirembe, F M

2004-02-01

Maternal mortality in Uganda has remained unchanged at 500/100 000 over the past 10 years despite concerted efforts to improve the standard of maternity care. It is especially difficult to improve standards in rural areas, where there is little money for improvements. Furthermore, staff may be isolated, poorly paid, disempowered, lacking in morale, and have few skills to bring about change. Training programme to introduce criteria based audit into rural Uganda. Makerere University Medical School, Mulago Hospital (large government teaching hospital in Kampala), and Mpigi District (rural area with 10 small health centres around a district hospital). Didactic teaching about criteria based audit followed by practical work in own units, with ongoing support and follow up workshops. Improvements were seen in many standards of care. Staff showed universal enthusiasm for the training; many staff produced simple, cost-free improvements in their standard of care. Teaching of criteria based audit to those providing health care in developing countries can produce low cost improvements in the standards of care. Because the method is simple and can be used to provide improvements even without new funding, it has the potential to produce sustainable and cost effective changes in the standard of health care. Follow up is needed to prevent a waning of enthusiasm with time.

49 CFR 236.202 - Signal governing movements over hand-operated switch.

Code of Federal Regulations, 2011 CFR

2011-10-01

... THE INSTALLATION, INSPECTION, MAINTENANCE, AND REPAIR OF SIGNAL AND TRAIN CONTROL SYSTEMS, DEVICES, AND APPLIANCES Automatic Block Signal Systems Standards § 236.202 Signal governing movements over hand...

Effect of standardized training on the reliability of the Cochrane risk of bias assessment tool: a prospective study.

PubMed

da Costa, Bruno R; Beckett, Brooke; Diaz, Alison; Resta, Nina M; Johnston, Bradley C; Egger, Matthias; Jüni, Peter; Armijo-Olivo, Susan

2017-03-03

The Cochrane risk of bias tool is commonly criticized for having a low reliability. We aimed to investigate whether training of raters, with objective and standardized instructions on how to assess risk of bias, can improve the reliability of the Cochrane risk of bias tool. In this pilot study, four raters inexperienced in risk of bias assessment were randomly allocated to minimal or intensive standardized training for risk of bias assessment of randomized trials of physical therapy treatments for patients with knee osteoarthritis pain. Two raters were experienced risk of bias assessors who served as reference. The primary outcome of our study was between-group reliability, defined as the agreement of the risk of bias assessments of inexperienced raters with the reference assessments of experienced raters. Consensus-based assessments were used for this purpose. The secondary outcome was within-group reliability, defined as the agreement of assessments within pairs of inexperienced raters. We calculated the chance-corrected weighted Kappa to quantify agreement within and between groups of raters for each of the domains of the risk of bias tool. A total of 56 trials were included in our analysis. The Kappa for the agreement of inexperienced raters with reference across items of the risk of bias tool ranged from 0.10 to 0.81 for the minimal training group and from 0.41 to 0.90 for the standardized training group. The Kappa values for the agreement within pairs of inexperienced raters across the items of the risk of bias tool ranged from 0 to 0.38 for the minimal training group and from 0.93 to 1 for the standardized training group. Between-group differences in Kappa for the agreement of inexperienced raters with reference always favored the standardized training group and was most pronounced for incomplete outcome data (difference in Kappa 0.52, p < 0.001) and allocation concealment (difference in Kappa 0.30, p = 0.004). Intensive, standardized training on risk of bias assessment may significantly improve the reliability of the Cochrane risk of bias tool.

The effectiveness of using standardized patients to improve community physician skills in mammography counseling and clinical breast exam.

PubMed

Costanza, M E; Luckmann, R; Quirk, M E; Clemow, L; White, M J; Stoddard, A M

1999-10-01

Traditional didactic continuing education is relatively ineffective in improving physicians' clinical skills. We hypothesized that a centralized course including small group workshops utilizing standardized patients could improve clinical skills for a reasonable cost. We designed a 5-h course aimed at improving physicians' counseling skills (re: screening mammography) and clinical breast exam (CBE) skills. The course included lectures, demonstrations, and small group skills sessions utilizing standardized patients and was offered to 156 typical community-based primary care physicians. Pre- and postcourse evaluation included in-office assessments of physician CBE and counseling performance by standardized patients and a written test of knowledge and attitudes. A total of 54.5% of eligible physicians participated. They improved modestly in only one of three areas of counseling skills measured (providing counseling appropriate to the patient's readiness to accept mammography, P = 0.01). The overall CBE score increased substantially from 24.8 to 34.7 (P < 0.0001). Knowledge in all areas measured and confidence in counseling patients also increased. The basic course cost $202 per physician trained. Most community-based primary care physicians may find small group training and in-office evaluation involving standardized patients acceptable. Such training may be more effective in improving physical exam skills than complex communication skills.

Vocational Training in Chile: A Decentralized and Market Oriented System. Training Policy Study No. 8.

ERIC Educational Resources Information Center

Espinoza, Eduardo Martinez

From 1976 to 1983 major reforms were enacted in Chile in the vocational training systems, based on four principles: decentralization, integration, diversification, and participation. The vocational training system in Chile is a legally established, market-oriented system in which many private training agencies compete to sell their services to…

Implementing Competency-Based Medical Education in a Postgraduate Family Medicine Residency Training Program: A Stepwise Approach, Facilitating Factors, and Processes or Steps That Would Have Been Helpful.

PubMed

Schultz, Karen; Griffiths, Jane

2016-05-01

In 2009-2010, the postgraduate residency training program at the Department of Family Medicine, Queen's University, wrestled with the practicalities of competency-based medical education (CBME) implementation when its accrediting body, the College of Family Physicians of Canada, introduced the competency-based Triple C curriculum. The authors used a stepwise approach to implement CMBE; the steps were to (1) identify objectives, (2) identify competencies, (3) map objectives and competencies to learning experiences and assessment processes, (4) plan learning experiences, (5) develop an assessment system, (6) collect and interpret data, (7) adjust individual residents' training programs, and (8) distribute decisions to stakeholders. The authors also note overarching processes, costs, and facil itating factors and processes or steps that would have been helpful for CBME implementation. Early outcomes are encouraging. Residents are being directly observed more often with increased documented feedback about performance based on explicit competency standards (24,000 data points for 150 residents from 2013 to 2015). These multiple observations are being collated in a way that is allowing the identification of patterns of performance, red flags, and competency development trajectory. Outliers are being identified earlier, resulting in earlier individualized modification of their residency training program. The authors will continue to provide and refine faculty development, are developing an entrustable professional activity field note app for handheld devices, and are undertaking research to explore what facilitates learners' competency development, what increases assessors' confidence in making competence decisions, and whether residents are better trained as a result of CBME implementation.

Evaluating the Good Ontology Design Guideline (GoodOD) with the Ontology Quality Requirements and Evaluation Method and Metrics (OQuaRE)

PubMed Central

Duque-Ramos, Astrid; Boeker, Martin; Jansen, Ludger; Schulz, Stefan; Iniesta, Miguela; Fernández-Breis, Jesualdo Tomás

2014-01-01

Objective To (1) evaluate the GoodOD guideline for ontology development by applying the OQuaRE evaluation method and metrics to the ontology artefacts that were produced by students in a randomized controlled trial, and (2) informally compare the OQuaRE evaluation method with gold standard and competency questions based evaluation methods, respectively. Background In the last decades many methods for ontology construction and ontology evaluation have been proposed. However, none of them has become a standard and there is no empirical evidence of comparative evaluation of such methods. This paper brings together GoodOD and OQuaRE. GoodOD is a guideline for developing robust ontologies. It was previously evaluated in a randomized controlled trial employing metrics based on gold standard ontologies and competency questions as outcome parameters. OQuaRE is a method for ontology quality evaluation which adapts the SQuaRE standard for software product quality to ontologies and has been successfully used for evaluating the quality of ontologies. Methods In this paper, we evaluate the effect of training in ontology construction based on the GoodOD guideline within the OQuaRE quality evaluation framework and compare the results with those obtained for the previous studies based on the same data. Results Our results show a significant effect of the GoodOD training over developed ontologies by topics: (a) a highly significant effect was detected in three topics from the analysis of the ontologies of untrained and trained students; (b) both positive and negative training effects with respect to the gold standard were found for five topics. Conclusion The GoodOD guideline had a significant effect over the quality of the ontologies developed. Our results show that GoodOD ontologies can be effectively evaluated using OQuaRE and that OQuaRE is able to provide additional useful information about the quality of the GoodOD ontologies. PMID:25148262

Evaluating the Good Ontology Design Guideline (GoodOD) with the ontology quality requirements and evaluation method and metrics (OQuaRE).

PubMed

Duque-Ramos, Astrid; Boeker, Martin; Jansen, Ludger; Schulz, Stefan; Iniesta, Miguela; Fernández-Breis, Jesualdo Tomás

2014-01-01

To (1) evaluate the GoodOD guideline for ontology development by applying the OQuaRE evaluation method and metrics to the ontology artefacts that were produced by students in a randomized controlled trial, and (2) informally compare the OQuaRE evaluation method with gold standard and competency questions based evaluation methods, respectively. In the last decades many methods for ontology construction and ontology evaluation have been proposed. However, none of them has become a standard and there is no empirical evidence of comparative evaluation of such methods. This paper brings together GoodOD and OQuaRE. GoodOD is a guideline for developing robust ontologies. It was previously evaluated in a randomized controlled trial employing metrics based on gold standard ontologies and competency questions as outcome parameters. OQuaRE is a method for ontology quality evaluation which adapts the SQuaRE standard for software product quality to ontologies and has been successfully used for evaluating the quality of ontologies. In this paper, we evaluate the effect of training in ontology construction based on the GoodOD guideline within the OQuaRE quality evaluation framework and compare the results with those obtained for the previous studies based on the same data. Our results show a significant effect of the GoodOD training over developed ontologies by topics: (a) a highly significant effect was detected in three topics from the analysis of the ontologies of untrained and trained students; (b) both positive and negative training effects with respect to the gold standard were found for five topics. The GoodOD guideline had a significant effect over the quality of the ontologies developed. Our results show that GoodOD ontologies can be effectively evaluated using OQuaRE and that OQuaRE is able to provide additional useful information about the quality of the GoodOD ontologies.

An analysis of image storage systems for scalable training of deep neural networks

DOE Office of Scientific and Technical Information (OSTI.GOV)

Lim, Seung-Hwan; Young, Steven R; Patton, Robert M

This study presents a principled empirical evaluation of image storage systems for training deep neural networks. We employ the Caffe deep learning framework to train neural network models for three different data sets, MNIST, CIFAR-10, and ImageNet. While training the models, we evaluate five different options to retrieve training image data: (1) PNG-formatted image files on local file system; (2) pushing pixel arrays from image files into a single HDF5 file on local file system; (3) in-memory arrays to hold the pixel arrays in Python and C++; (4) loading the training data into LevelDB, a log-structured merge tree based key-valuemore » storage; and (5) loading the training data into LMDB, a B+tree based key-value storage. The experimental results quantitatively highlight the disadvantage of using normal image files on local file systems to train deep neural networks and demonstrate reliable performance with key-value storage based storage systems. When training a model on the ImageNet dataset, the image file option was more than 17 times slower than the key-value storage option. Along with measurements on training time, this study provides in-depth analysis on the cause of performance advantages/disadvantages of each back-end to train deep neural networks. We envision the provided measurements and analysis will shed light on the optimal way to architect systems for training neural networks in a scalable manner.« less

Standard guidelines of care: laser and IPL hair reduction.

PubMed

Buddhadev, Rajesh M

2008-01-01

Laser-assisted hair removal, Laser hair removal, Laser and light-assisted hair removal, Laser and light-assisted, long-term hair reduction, IPL photodepilation, LHE photodepilation; all these are acceptable synonyms. Laser (Ruby, Nd Yag, Alexandrite, Diode), intense pulse light, light and heat energy system are the different light-/Laser-based systems used for hair removal; each have its advantages and disadvantages. The word "LONG-TERM HAIR REDUCTION" should be used rather than permanent hair removal. Patient counseling is essential about the need for multiple sessions. PHYSICIANS' QUALIFICATIONS: Laser hair removal may be practiced by any dermatologist, who has received adequate background training during postgraduation or later at a centre that provides education and training in Lasers or in focused workshops providing such training. The dermatologist should have adequate knowledge of the machines, the parameters and aftercare. The physician may allow the actual procedure to be performed under his/her direct supervision by a trained nurse assistant/junior doctor. However, the final responsibility for the procedure would lie with the physician. The procedure may be performed in the physician's minor procedure room. Investigations to rule out any underlying cause for hair growth are important; concurrent drug therapy may be needed. Laser parameters vary with area, type of hair, and the machine used. Full knowledge about the machine and cooling system is important. Future maintenance treatments may be needed.

Implementation research: a mentoring programme to improve laboratory quality in Cambodia

PubMed Central

Voeurng, Vireak; Sek, Sophat; Song, Sophanna; Vong, Nora; Tous, Chansamrach; Flandin, Jean-Frederic; Confer, Deborah; Costa, Alexandre; Martin, Robert

2016-01-01

Abstract Objective To implement a mentored laboratory quality stepwise implementation (LQSI) programme to strengthen the quality and capacity of Cambodian hospital laboratories. Methods We recruited four laboratory technicians to be mentors and trained them in mentoring skills, laboratory quality management practices and international standard organization (ISO) 15189 requirements for medical laboratories. Separately, we trained staff from 12 referral hospital laboratories in laboratory quality management systems followed by tri-weekly in-person mentoring on quality management systems implementation using the LQSI tool, which is aligned with the ISO 15189 standard. The tool was adapted from a web-based resource into a software-based spreadsheet checklist, which includes a detailed action plan and can be used to qualitatively monitor each laboratory’s progress. The tool – translated into Khmer – included a set of quality improvement activities grouped into four phases for implementation with increasing complexity. Project staff reviewed the laboratories’ progress and challenges in weekly conference calls and bi-monthly meetings with focal points of the health ministry, participating laboratories and local partners. We present the achievements in implementation from September 2014 to March 2016. Findings As of March 2016, the 12 laboratories have completed 74–90% of the 104 activities in phase 1, 53–78% of the 178 activities in phase 2, and 18–26% of the 129 activities in phase 3. Conclusion Regular on-site mentoring of laboratories using a detailed action plan in the local language allows staff to learn concepts of quality management system and learn on the job without disruption to laboratory service provision. PMID:27843164

Digital hand atlas for web-based bone age assessment: system design and implementation

NASA Astrophysics Data System (ADS)

Cao, Fei; Huang, H. K.; Pietka, Ewa; Gilsanz, Vicente

2000-04-01

A frequently used assessment method of skeletal age is atlas matching by a radiological examination of a hand image against a small set of Greulich-Pyle patterns of normal standards. The method however can lead to significant deviation in age assessment, due to a variety of observers with different levels of training. The Greulich-Pyle atlas based on middle upper class white populations in the 1950s, is also not fully applicable for children of today, especially regarding the standard development in other racial groups. In this paper, we present our system design and initial implementation of a digital hand atlas and computer-aided diagnostic (CAD) system for Web-based bone age assessment. The digital atlas will remove the disadvantages of the currently out-of-date one and allow the bone age assessment to be computerized and done conveniently via Web. The system consists of a hand atlas database, a CAD module and a Java-based Web user interface. The atlas database is based on a large set of clinically normal hand images of diverse ethnic groups. The Java-based Web user interface allows users to interact with the hand image database form browsers. Users can use a Web browser to push a clinical hand image to the CAD server for a bone age assessment. Quantitative features on the examined image, which reflect the skeletal maturity, is then extracted and compared with patterns from the atlas database to assess the bone age.

49 CFR 236.204 - Track signaled for movements in both directions, requirements.

Code of Federal Regulations, 2010 CFR

2010-10-01

... THE INSTALLATION, INSPECTION, MAINTENANCE, AND REPAIR OF SIGNAL AND TRAIN CONTROL SYSTEMS, DEVICES, AND APPLIANCES Automatic Block Signal Systems Standards § 236.204 Track signaled for movements in both...

49 CFR 236.204 - Track signaled for movements in both directions, requirements.

Code of Federal Regulations, 2011 CFR

2011-10-01

... THE INSTALLATION, INSPECTION, MAINTENANCE, AND REPAIR OF SIGNAL AND TRAIN CONTROL SYSTEMS, DEVICES, AND APPLIANCES Automatic Block Signal Systems Standards § 236.204 Track signaled for movements in both...

Class of 1994, Annual Report: NH Technical Colleges and Institute and NH Police Standards and Training.

ERIC Educational Resources Information Center

New Hampshire State Dept. of Postsecondary Technical Education, Concord.

This 1994 annual report for the New Hampshire Technical Colleges and Institute System (NHTC&IS) includes information on enrollments, outcomes, job placement, average salaries, transfer institutions, work force training, the Police Academy, finances, future directions, and governance. Introductory material highlights the following…

NHEXAS PHASE I MARYLAND STUDY--STANDARD OPERATING PROCEDURE FOR TRAINING OF PHLEBOTOMISTS (G10)

EPA Science Inventory

The purpose of this SOP is to outline the responsibilities of the phlebotomist before, during, and after sampling at residences; and the training system that teaches phlebotomists what they need to know to handle these responsibilities. The overall responsibilities are to collec...

78 FR 54952 - Petition for Waiver of Compliance

Federal Register 2010, 2011, 2012, 2013, 2014

2013-09-06

... Administration (FRA) for a waiver of compliance from certain provisions of the Federal railroad safety regulations contained at 49 CFR Part 232, Brake System Safety Standards for Freight and Other Non- Passenger Trains and Equipment; End-of-Train Devices. FRA assigned the petition Docket Number FRA-2013-0080. In its...

78 FR 47823 - Petition for Waiver of Compliance

Federal Register 2010, 2011, 2012, 2013, 2014

2013-08-06

... Administration (FRA) for a waiver of compliance from certain provisions of the Federal railroad safety regulations contained at 49 CFR Part 232, Brake System Safety Standards for Freight and Other Non-Passenger Trains and Equipment; End-of-Train Devices. FRA assigned the petition Docket Number FRA-2013-0069...

Video game-based neuromuscular electrical stimulation system for calf muscle training: a case study.

PubMed

Sayenko, D G; Masani, K; Milosevic, M; Robinson, M F; Vette, A H; McConville, K M V; Popovic, M R

2011-03-01

A video game-based training system was designed to integrate neuromuscular electrical stimulation (NMES) and visual feedback as a means to improve strength and endurance of the lower leg muscles, and to increase the range of motion (ROM) of the ankle joints. The system allowed the participants to perform isotonic concentric and isometric contractions in both the plantarflexors and dorsiflexors using NMES. In the proposed system, the contractions were performed against exterior resistance, and the angle of the ankle joints was used as the control input to the video game. To test the practicality of the proposed system, an individual with chronic complete spinal cord injury (SCI) participated in the study. The system provided a progressive overload for the trained muscles, which is a prerequisite for successful muscle training. The participant indicated that he enjoyed the video game-based training and that he would like to continue the treatment. The results show that the training resulted in a significant improvement of the strength and endurance of the paralyzed lower leg muscles, and in an increased ROM of the ankle joints. Video game-based training programs might be effective in motivating participants to train more frequently and adhere to otherwise tedious training protocols. It is expected that such training will not only improve the properties of their muscles but also decrease the severity and frequency of secondary complications that result from SCI. Copyright © 2010 IPEM. All rights reserved.

Development of an intelligent surgical training system for Thoracentesis.

PubMed

Nakawala, Hirenkumar; Ferrigno, Giancarlo; De Momi, Elena

2018-01-01

Surgical training improves patient care, helps to reduce surgical risks, increases surgeon's confidence, and thus enhances overall patient safety. Current surgical training systems are more focused on developing technical skills, e.g. dexterity, of the surgeons while lacking the aspects of context-awareness and intra-operative real-time guidance. Context-aware intelligent training systems interpret the current surgical situation and help surgeons to train on surgical tasks. As a prototypical scenario, we chose Thoracentesis procedure in this work. We designed the context-aware software framework using the surgical process model encompassing ontology and production rules, based on the procedure descriptions obtained through textbooks and interviews, and ontology-based and marker-based object recognition, where the system tracked and recognised surgical instruments and materials in surgeon's hands and recognised surgical instruments on the surgical stand. The ontology was validated using annotated surgical videos, where the system identified "Anaesthesia" and "Aspiration" phase with 100% relative frequency and "Penetration" phase with 65% relative frequency. The system tracked surgical swab and 50mL syringe with approximately 88.23% and 100% accuracy in surgeon's hands and recognised surgical instruments with approximately 90% accuracy on the surgical stand. Surgical workflow training with the proposed system showed equivalent results as the traditional mentor-based training regime, thus this work is a step forward a new tool for context awareness and decision-making during surgical training. Copyright © 2017 Elsevier B.V. All rights reserved.

Effectiveness of simulator-based echocardiography training of noncardiologists in congenital heart diseases.

PubMed

Wagner, Robert; Razek, Vit; Gräfe, Florentine; Berlage, Thomas; Janoušek, Jan; Daehnert, Ingo; Weidenbach, Michael

2013-07-01

Congenital heart diseases (CHD) are responsible for substantial morbidity and mortality in neonates. The preliminary diagnosis often is made by noncardiologists. For this reason, there is a huge demand of training in echocardiography of CHD. This is difficult to achieve due to limited resources of specialized centers. The goal of this study was to investigate the training effect of the echocardiography simulator EchoCom on trainee's ability to diagnose CHD. We enrolled 10 residents for simulator-based training in echocardiography of CHD. All participants were instructed on the simulator's basic handling and had one hour to scan the first 9 datasets information (ventricular septal defect, atrial septal defect, atrioventricular septal defect, Tetralogy of Fallot, transposition of great arteries, congenital corrected transposition of great arteries, common arterial trunk, hypoplastic left heart syndrome, normal anatomy) and establish a diagnosis. No help was given except for support regarding simulator related issues. Afterward, 2 rounds of structured simulator based echocardiography training focused on echocardiographic anatomy, spatial orientation, standard views, and echocardiographic anatomy of different CHD followed. All participants completed a standardized questionnaire containing 10 multiple-choice (MC) questions focusing on basic theoretical knowledge in echocardiographic anatomy and common CHD. Almost all of the residents invited from the affiliated children's hospital had little (20%) or no experience (80%) in echocardiography of CHD. Their Pretest and Posttest scores showed significant improvement for both, MC test and performance test, respectively. Our study showed that simulator-based training in echocardiography in CHD could be very effective and may assist with training outside the scope of CHD. © 2013, Wiley Periodicals, Inc.

Design and Validation of a Radio-Frequency Identification-Based Device for Routinely Assessing Gait Speed in a Geriatrics Clinic.

PubMed

Barry, Lisa C; Hatchman, Laura; Fan, Zhaoyan; Guralnik, Jack M; Gao, Robert X; Kuchel, George A

2018-05-01

To evaluate the feasibility, acceptability, and validity of a radio-frequency identification (RFID)-based system to measure gait speed in a clinical setting as a first step to using unobtrusive gait speed assessment in routine clinical care. Feasibility study comparing gait speed assessed using an RFID-based system with gait speed assessed using handheld stopwatch, the criterion standard. Outpatient geriatrics clinic at a Connecticut-based academic medical center. Clinic attendees who could walk independently with or without an assistive device (N=50) and healthcare providers (N=9). Gait speed was measured in twice using 2 methods each time before participants entered an examination room. Participants walked at their usual pace while gait speed was recorded simultaneously using the RFID-based system and a handheld stopwatch operated by a trained study investigator. After 2 trials, participants completed a brief survey regarding their experience. At the end of the study period, clinic healthcare providers completed a separate survey. Test-retest reliability of the RFID-based system was high (intraclass correlation coefficient = 0.953). The mean difference ± standard deviation in gait speed between the RFID-based system and the stopwatch was -0.003±0.035 m/s (p=.53) and did not differ significantly according to age, sex, or use of an assistive walking aid. Acceptability of the device was high, and 8 of 9 providers indicated that measuring gait speed using the RFID-based system should be a part of routine clinical care. RFID technology may offer a practical means of overcoming barriers to routine measurement of gait speed in real-world outpatient clinical settings. © 2018, Copyright the Authors Journal compilation © 2018, The American Geriatrics Society.

76 FR 63899 - Positive Train Control Systems

Federal Register 2010, 2011, 2012, 2013, 2014

2011-10-14

...-0028, Notice No. 2] RIN 2130-AC27 Positive Train Control Systems AGENCY: Federal Railroad...-based criteria in order to avoid positive train control (PTC) system implementation on track segments... and Compliance, Staff Director, Signal & Train Control Division, Federal Railroad Administration, Mail...

Novel Television-Based Cognitive Training Improves Working Memory and Executive Function

PubMed Central

Shatil, Evelyn; Mikulecká, Jaroslava; Bellotti, Francesco; Bureš, Vladimír

2014-01-01

The main study objective was to investigate the effect of interactive television-based cognitive training on cognitive performance of 119 healthy older adults, aged 60–87 years. Participants were randomly allocated to a cognitive training group or to an active control group in a single-blind controlled two-group design. Before and after training interactive television cognitive performance was assessed on well validated tests of fluid, higher-order ability, and system usability was evaluated. The participants in the cognitive training group completed a television-based cognitive training programme, while the participants in the active control group completed a TV-based programme of personally benefiting activities. Significant improvements were observed in well validated working memory and executive function tasks in the cognitive training but not in the control group. None of the groups showed statistically significant improvement in life satisfaction score. Participants' reports of “adequate” to “high” system usability testify to the successful development and implementation of the interactive television-based system and compliant cognitive training contents. The study demonstrates that cognitive training delivered by means of an interactive television system can generate genuine cognitive benefits in users and these are measurable using well-validated cognitive tests. Thus, older adults who cannot use or afford a computer can easily use digital interactive television to benefit from advanced software applications designed to train cognition. PMID:24992187

Design of Customizable Automated Low Cost Eye Testing System

PubMed Central

K, Ganesan; D, Shalini

2014-01-01

Background and Objectives: In many underdeveloped and third world countries, eye care is often neglected due to illiteracy. Particularly people in rural areas suffer with eye problems due to mal nutrition. The government is spending lot of money and efforts in screening the people at periodic intervals. One of the challenges faced by the doctors is screening the school children. Materials and Methods: The standard Snellen letter chart based diagnostic system does not work always. There are instances where the first few students who undergo this diagnostic system, memorize the letter sequence of the Snellen letter chart and convey the same to other fellow students. Hence other students simply read out the Snellen letter sequence from their memory, not by looking at the Snellen letter chart. Thus there is a need of randomizing the sequence of letters being displayed on the Snellen letter chart for every student to be diagnosed for eye testing. Conclusion: In the present paper we are proposing a customizable, software based, cost effective solution which involves a standard personal computer (PC) fitted with a camera, headphone and speaker system. The envisaged system can be administered even by the trained persons. The proposed system is also suitable for remote diagnosis of patients, particularly in the field of telemedicine. PMID:24783089

A Computer-Based Training System for American Antique Chair Styles.

ERIC Educational Resources Information Center

See, Maha

A computer-based training (CBT) system was designed to train learners to recognize six styles of 18th century American antique chairs. The project consisted of five phases. The first phase consisted of a needs analysis to determine the training needs for the target population. Three groups of learners were identified: antique sales personnel,…

The Training Information Management System. Volume 2. Phase 2 evaluation Report

DTIC Science & Technology

1986-07-01

The Training Information Management System (TIMS) is a computer-based system which can be used by Army personnel to collect and display training...but resides at a fixed location (e.g., the unit headquarters). This research note documents an evaluation of the Training Information Management System .

Using an object-based grid system to evaluate a newly developed EP approach to formulate SVMs as applied to the classification of organophosphate nerve agents

NASA Astrophysics Data System (ADS)

Land, Walker H., Jr.; Lewis, Michael; Sadik, Omowunmi; Wong, Lut; Wanekaya, Adam; Gonzalez, Richard J.; Balan, Arun

2004-04-01

This paper extends the classification approaches described in reference [1] in the following way: (1.) developing and evaluating a new method for evolving organophosphate nerve agent Support Vector Machine (SVM) classifiers using Evolutionary Programming, (2.) conducting research experiments using a larger database of organophosphate nerve agents, and (3.) upgrading the architecture to an object-based grid system for evaluating the classification of EP derived SVMs. Due to the increased threats of chemical and biological weapons of mass destruction (WMD) by international terrorist organizations, a significant effort is underway to develop tools that can be used to detect and effectively combat biochemical warfare. This paper reports the integration of multi-array sensors with Support Vector Machines (SVMs) for the detection of organophosphates nerve agents using a grid computing system called Legion. Grid computing is the use of large collections of heterogeneous, distributed resources (including machines, databases, devices, and users) to support large-scale computations and wide-area data access. Finally, preliminary results using EP derived support vector machines designed to operate on distributed systems have provided accurate classification results. In addition, distributed training time architectures are 50 times faster when compared to standard iterative training time methods.

Advances in the TRIDEC Cloud

NASA Astrophysics Data System (ADS)

Hammitzsch, Martin; Spazier, Johannes; Reißland, Sven

2016-04-01

The TRIDEC Cloud is a platform that merges several complementary cloud-based services for instant tsunami propagation calculations and automated background computation with graphics processing units (GPU), for web-mapping of hazard specific geospatial data, and for serving relevant functionality to handle, share, and communicate threat specific information in a collaborative and distributed environment. The platform offers a modern web-based graphical user interface so that operators in warning centres and stakeholders of other involved parties (e.g. CPAs, ministries) just need a standard web browser to access a full-fledged early warning and information system with unique interactive features such as Cloud Messages and Shared Maps. Furthermore, the TRIDEC Cloud can be accessed in different modes, e.g. the monitoring mode, which provides important functionality required to act in a real event, and the exercise-and-training mode, which enables training and exercises with virtual scenarios re-played by a scenario player. The software system architecture and open interfaces facilitate global coverage so that the system is applicable for any region in the world and allow the integration of different sensor systems as well as the integration of other hazard types and use cases different to tsunami early warning. Current advances of the TRIDEC Cloud platform will be summarized in this presentation.

Bridging the gap in complementary and alternative medicine research: manualization as a means of promoting standardization and flexibility of treatment in clinical trials of acupuncture.

PubMed

Schnyer, Rosa N; Allen, John J B

2002-10-01

An important methodological challenge encountered in acupuncture clinical research involves the design of treatment protocols that help ensure standardization and replicability while allowing for the necessary flexibility to tailor treatments to each individual. Manualization of protocols used in clinical trials of acupuncture and other traditionally-based complementary and alternative medicine (CAM) systems facilitates the systematic delivery of replicable and standardized, yet individually-tailored treatments. To facilitate high-quality CAM acupuncture research by outlining a method for the systematic design and implementation of protocols used in CAM clinical trials based on the concept of treatment manualization. A series of treatment manuals was developed to systematically articulate the Chinese medical theoretical and clinical framework for a given Western-defined illness, to increase the quality and consistency of treatment, and to standardize the technical aspects of the protocol. In all, three manuals were developed for National Institutes of Health (NIH)-funded clinical trials of acupuncture for depression, spasticity in cerebral palsy, and repetitive stress injury. In Part I, the rationale underlying these manuals and the challenges encountered in creating them are discussed, and qualitative assessments of their utility are provided. In Part II, a methodology to develop treatment manuals for use in clinical trials is detailed, and examples are given. A treatment manual provides a precise way to train and supervise practitioners, enable evaluation of conformity and competence, facilitate the training process, and increase the ability to identify the active therapeutic ingredients in clinical trials of acupuncture.

Impact of Mindfulness-Based Teacher Training on MBSR Participant Well-Being Outcomes and Course Satisfaction.

PubMed

Ruijgrok-Lupton, Pauline Eva; Crane, Rebecca S; Dorjee, Dusana

2018-01-01

Growing interest in mindfulness-based programs (MBPs) has resulted in increased demand for MBP teachers, raising questions around safeguarding teaching standards. Training literature emphasises the need for appropriate training and meditation experience, yet studies into impact of such variables on participant outcomes are scarce, requiring further investigation. This feasibility pilot study hypothesised that participant outcomes would relate to teachers' mindfulness-based teacher training levels and mindfulness-based teaching and meditation experience. Teachers ( n  = 9) with different MBP training levels delivering mindfulness-based stress reduction (MBSR) courses to the general public were recruited together with their course participants ( n  = 31). A teacher survey collected data on their mindfulness-based teacher training, other professional training and relevant experience. Longitudinal evaluations using online questionnaires measured participant mindfulness and well-being before and after MBSR and participant course satisfaction. Course attendees' gains after the MBSR courses were correlated with teacher training and experience. Gains in well-being and reductions in perceived stress were significantly larger for the participant cohort taught by teachers who had completed an additional year of mindfulness-based teacher training and assessment. No correlation was found between course participants' outcomes and their teacher's mindfulness-based teaching and meditation experience. Our results support the hypothesis that higher mindfulness-based teacher training levels are possibly linked to more positive participant outcomes, with implications for training in MBPs. These initial findings highlight the need for further research on mindfulness-based teacher training and course participant outcomes with larger participant samples.

Training And Supervision Did Not Meaningfully Improve Quality Of Care For Pregnant Women Or Sick Children In Sub-Saharan Africa.

PubMed

Leslie, Hannah H; Gage, Anna; Nsona, Humphreys; Hirschhorn, Lisa R; Kruk, Margaret E

2016-09-01

In-service training courses and supportive supervision of health workers are among the most common interventions to improve the quality of health care in low- and middle-income countries. Despite extensive investment from donors, evaluations of the long-term effect of these two interventions are scarce. We used nationally representative surveys of health systems in seven countries in sub-Saharan Africa to examine the association of in-service training and supervision with provider quality in antenatal and sick child care. The results of our analysis showed that observed quality of care was poor, with fewer than half of evidence-based actions completed by health workers, on average. In-service training and supervision were associated with quality of sick child care; they were associated with quality of antenatal care only when provided jointly. All associations were modest-at most, improvements related to interventions were equivalent to 2 additional provider actions out of the 18-40 actions expected per visit. In-service training and supportive supervision as delivered were not sufficient to meaningfully improve the quality of care in these countries. Greater attention to the quality of health professional education and national health system performance will be required to provide the standard of health care that patients deserve. Project HOPE—The People-to-People Health Foundation, Inc.

The spread of European models of engineering education: the challenges faced in emerging countries

NASA Astrophysics Data System (ADS)

Gardelle, Linda; Cardona Gil, Emmanuel; Benguerna, Mohamed; Bolat, Altangul; Naran, Boldmaa

2017-03-01

The major European models of engineering training (the German, the British and the French model) spread throughout the world during the twentieth century. Historical heritage, cultural proximity and languages explain the open expression of faithfulness to one system in some countries. In these countries, the national standards inherited are now completed by international standards or are in direct competition with new influences. This article will attempt, through the existing literature, interviews and on-site investigations, to analyse current engineering training in some emerging countries and its relations with European models, the objective being to analyse the evolution of local systems and so the challenges and issues raised by the dissemination of European models.

[Standardization and modeling of surgical processes].

PubMed

Strauss, G; Schmitz, P

2016-12-01

Due to the technological developments around the operating room, surgery in the twenty-first century is undergoing a paradigm shift. Which technologies have already been integrated into the surgical routine? How can a favorable cost-benefit balance be achieved by the implementation of new software-based assistance systems? This article presents the state of the art technology as exemplified by a semi-automated operation system for otorhinolaryngology surgery. The main focus is on systems for implementation of digital handbooks and navigational functions in situ. On the basis of continuous development in digital imaging, decisions may by facilitated by individual patient models thus allowing procedures to be optimized. The ongoing digitization and linking of all relevant information enable a high level of standardization in terms of operating procedures. This may be used by assistance systems as a basis for complete documentation and high process reliability. Automation of processes in the operating room results in an increase in quality, precision and standardization so that the effectiveness and efficiency of treatment can be improved; however, care must be taken that detrimental consequences, such as loss of skills and placing too much faith in technology must be avoided by adapted training concepts.

Development of national standardized all-hazard disaster core competencies for acute care physicians, nurses, and EMS professionals.

PubMed

Schultz, Carl H; Koenig, Kristi L; Whiteside, Mary; Murray, Rick

2012-03-01

The training of medical personnel to provide care for disaster victims is a priority for the physician community, the federal government, and society as a whole. Course development for such training guided by well-accepted standardized core competencies is lacking, however. This project identified a set of core competencies and performance objectives based on the knowledge, skills, and attitudes required by the specific target audience (emergency department nurses, emergency physicians, and out-of-hospital emergency medical services personnel) to ensure they can treat the injuries and illnesses experienced by victims of disasters regardless of cause. The core competencies provide a blueprint for the development or refinement of disaster training courses. This expert consensus project, supported by a grant from the Robert Wood Johnson Foundation, incorporated an all-hazard, comprehensive emergency management approach addressing every type of disaster to minimize the effect on the public's health. An instructional systems design process was used to guide the development of audience-appropriate competencies and performance objectives. Participants, representing multiple academic and provider organizations, used a modified Delphi approach to achieve consensus on recommendations. A framework of 19 content categories (domains), 19 core competencies, and more than 90 performance objectives was developed for acute medical care personnel to address the requirements of effective all-hazards disaster response. Creating disaster curricula and training based on the core competencies and performance objectives identified in this article will ensure that acute medical care personnel are prepared to treat patients and address associated ramifications/consequences during any catastrophic event. Copyright © 2012 American College of Emergency Physicians. Published by Mosby, Inc. All rights reserved.

The transition to competency-based pediatric training in the United Arab Emirates.

PubMed

Ibrahim, Halah; Al Tatari, Hossam; Holmboe, Eric S

2015-04-01

Although competency-based medical education has become the standard for physician training in the West, many developing countries have not yet adopted competency-based training. In 2009 in the United Arab Emirates, the government regulatory and operational authorities for healthcare in Abu Dhabi mandated a wide-scale reform of the emirate's postgraduate residency programs to the competency-based framework of the newly formed Accreditation Council for Graduate Medical Education-International (ACGME-I). This article briefly describes the rationale for competency-based medical education and provides an overview of the transition from traditional, time-based residency training to competency-based postgraduate medical education for the Pediatrics residency programs in Abu Dhabi. We will provide data on the initial impact of this transition on resident performance and patient outcomes in a Pediatrics residency program in an academic medical center in the United Arab Emirates.

General Training System; GENTRAS. Final Report.

ERIC Educational Resources Information Center

International Business Machines Corp., Gaithersburg, MD. Federal Systems Div.

GENTRAS (General Training System) is a computer-based training model for the Marine Corps which makes use of a systems approach. The model defines the skill levels applicable for career growth and classifies and defines the training needed for this growth. It also provides a training cost subsystem which will provide a more efficient means of…

Robot-Assisted Training Early After Cardiac Surgery.

PubMed

Schoenrath, Felix; Markendorf, Susanne; Brauchlin, Andreas E; Seifert, Burkhardt; Wilhelm, Markus J; Czerny, Martin; Riener, Robert; Falk, Volkmar; Schmied, Christian M

2015-07-01

To assess feasibility and safety of a robot-assisted gait therapy with the Lokomat® system in patients early after open heart surgery. Within days after open heart surgery 10 patients were subjected to postoperative Lokomat® training (Intervention group, IG) whereas 20 patients served as controls undergoing standard postoperative physiotherapy (Control group, CG). All patients underwent six-minute walk test and evaluation of the muscular strength of the lower limbs by measuring quadriceps peak force. The primary safety end-point was freedom from any device-related wound healing disturbance. Patients underwent clinical follow-up after one month. Both training methods resulted in an improvement of walking distance (IG [median, interquartile range, p-value]: +119 m, 70-201 m, p = 0.005; CG: 105 m, 57-152.5m, p < 0.001) and quadriceps peak force (IG left: +5 N, 3.8 7 N, p = 0.005; IG right: +3.5 N, 1.5-8.8 N, p = 0.011; CG left: +5.5 N, 4-9 N, p < 0.001; CG right: +6 N, 4.3-9.8 N, p < 0.001) in all participants. Results with robot-assisted training were comparable to early postoperative standard in hospital training (median changes in walking distance in percent, p = 0.81; median changes in quadriceps peak force in percent, left: p = 0.97, right p = 0.61). No deep sternal wound infection or any adverse event occurred in the robot-assisted training group. Robot-assisted gait therapy with the Lokomat® system is feasible and safe in patients early after median sternotomy. Results with robot-assisted training were comparable to standard in hospital training. An adapted and combined aerobic and resistance training intervention with augmented feedback may result in benefits in walking distance and lower limb muscle strength (ClinicalTrials.gov number, NCT 02146196). © 2015 Wiley Periodicals, Inc.

78 FR 70888 - Need for Agency Approval of a Railroad's Use of Certain Technology That Has Been Previously...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-11-27

... technologies, namely safety-critical processor-based signal or train control systems, including subsystems and... or train control system (including a subsystem or component thereof) that was in service as of June 6... processor-based signal or train control system, subsystem, or component.'' See 49 CFR 236.903. Under Subpart...

Making the Grade: A Report on Standards in Work-Based Learning for Young People.

ERIC Educational Resources Information Center

Hughes, Maria

The reasons for the deterioration of the inspection grades awarded for work-based learning (WBL) provision in England were examined. The main data collection activities were as follows: (1) a statistical analysis of the Training Standards Council (TSC) and Adult Learning Inspectorate (ALI) inspection grades in 1998-2001; (2) a qualitative review…

NeuroRecovery Network provides standardization of locomotor training for persons with incomplete spinal cord injury.

PubMed

Morrison, Sarah A; Forrest, Gail F; VanHiel, Leslie R; Davé, Michele; D'Urso, Denise

2012-09-01

To illustrate the continuity of care afforded by a standardized locomotor training program across a multisite network setting within the Christopher and Dana Reeve Foundation NeuroRecovery Network (NRN). Single patient case study. Two geographically different hospital-based outpatient facilities. This case highlights a 25-year-old man diagnosed with C4 motor incomplete spinal cord injury with American Spinal Injury Association Impairment Scale grade D. Standardized locomotor training program 5 sessions per week for 1.5 hours per session, for a total of 100 treatment sessions, with 40 sessions at 1 center and 60 at another. Ten-meter walk test and 6-minute walk test were assessed at admission and discharge across both facilities. For each of the 100 treatment sessions percent body weight support, average, and maximum treadmill speed were evaluated. Locomotor endurance, as measured by the 6-minute walk test, and overground gait speed showed consistent improvement from admission to discharge. Throughout training, the patient decreased the need for body weight support and was able to tolerate faster treadmill speeds. Data indicate that the patient continued to improve on both treatment parameters and walking function. Standardization across the NRN centers provided a mechanism for delivering consistent and reproducible locomotor training programs across 2 facilities without disrupting training or recovery progression. Copyright © 2012 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

Reliability of anthropometric measurements in European preschool children: the ToyBox-study.

PubMed

De Miguel-Etayo, P; Mesana, M I; Cardon, G; De Bourdeaudhuij, I; Góźdź, M; Socha, P; Lateva, M; Iotova, V; Koletzko, B V; Duvinage, K; Androutsos, O; Manios, Y; Moreno, L A

2014-08-01

The ToyBox-study aims to develop and test an innovative and evidence-based obesity prevention programme for preschoolers in six European countries: Belgium, Bulgaria, Germany, Greece, Poland and Spain. In multicentre studies, anthropometric measurements using standardized procedures that minimize errors in the data collection are essential to maximize reliability of measurements. The aim of this paper is to describe the standardization process and reliability (intra- and inter-observer) of height, weight and waist circumference (WC) measurements in preschoolers. All technical procedures and devices were standardized and centralized training was given to the fieldworkers. At least seven children per country participated in the intra- and inter-observer reliability testing. Intra-observer technical error ranged from 0.00 to 0.03 kg for weight and from 0.07 to 0.20 cm for height, with the overall reliability being above 99%. A second training was organized for WC due to low reliability observed in the first training. Intra-observer technical error for WC ranged from 0.12 to 0.71 cm during the first training and from 0.05 to 1.11 cm during the second training, and reliability above 92% was achieved. Epidemiological surveys need standardized procedures and training of researchers to reduce measurement error. In the ToyBox-study, very good intra- and-inter-observer agreement was achieved for all anthropometric measurements performed. © 2014 World Obesity.

In situ health monitoring for bogie systems of CRH380 train on Beijing-Shanghai high-speed railway

NASA Astrophysics Data System (ADS)

Hong, Ming; Wang, Qiang; Su, Zhongqing; Cheng, Li

2014-04-01

Based on the authors' research efforts over the years, an in situ structural health monitoring (SHM) technique taking advantage of guided elastic waves has been developed and deployed via an online diagnosis system. The technique and the system were recently implemented on China's latest high-speed train (CRH380CL) operated on Beijing-Shanghai High-Speed Railway. The system incorporated modularized components including active sensor network, active wave generation, multi-channel data acquisition, signal processing, data fusion, and results presentation. The sensor network, inspired by a new concept—"decentralized standard sensing", was integrated into the bogie frames during the final assembly of CRH380CL, to generate and acquire bogie-guided ultrasonic waves, from which a wide array of signal features were extracted. Fusion of signal features through a diagnostic imaging algorithm led to a graphic illustration of the overall health state of the bogie in a real-time and intuitive manner. The in situ experimentation covered a variety of high-speed train operation events including startup, acceleration/deceleration, full-speed operation (300 km/h), emergency braking, track change, as well as full stop. Mock-up damage affixed to the bogie was identified quantitatively and visualized in images. This in situ testing has demonstrated the feasibility, effectiveness, sensitivity, and reliability of the developed SHM technique and the system towards real-world applications.

Human Engineering Guidelines for Management Information Systems. Change 1,

DTIC Science & Technology

1983-06-09

beginner . chapter offers guidelines concerning training. 0 A brief review available for the infrequent user. Major training factors * A program for a...the training include a program specifically designed L Li LL for the beginner or naive user? 8. Is there a brief review for the intermittent user? Ei Li...250 pages of text. Flowchart - A graphic representation, using standard symbols, which portrays logical data and process- ing requirements. Formatting

Deep learning-based artificial vision for grasp classification in myoelectric hands.

PubMed

Ghazaei, Ghazal; Alameer, Ali; Degenaar, Patrick; Morgan, Graham; Nazarpour, Kianoush

2017-06-01

Computer vision-based assistive technology solutions can revolutionise the quality of care for people with sensorimotor disorders. The goal of this work was to enable trans-radial amputees to use a simple, yet efficient, computer vision system to grasp and move common household objects with a two-channel myoelectric prosthetic hand. We developed a deep learning-based artificial vision system to augment the grasp functionality of a commercial prosthesis. Our main conceptual novelty is that we classify objects with regards to the grasp pattern without explicitly identifying them or measuring their dimensions. A convolutional neural network (CNN) structure was trained with images of over 500 graspable objects. For each object, 72 images, at [Formula: see text] intervals, were available. Objects were categorised into four grasp classes, namely: pinch, tripod, palmar wrist neutral and palmar wrist pronated. The CNN setting was first tuned and tested offline and then in realtime with objects or object views that were not included in the training set. The classification accuracy in the offline tests reached [Formula: see text] for the seen and [Formula: see text] for the novel objects; reflecting the generalisability of grasp classification. We then implemented the proposed framework in realtime on a standard laptop computer and achieved an overall score of [Formula: see text] in classifying a set of novel as well as seen but randomly-rotated objects. Finally, the system was tested with two trans-radial amputee volunteers controlling an i-limb Ultra TM prosthetic hand and a motion control TM prosthetic wrist; augmented with a webcam. After training, subjects successfully picked up and moved the target objects with an overall success of up to [Formula: see text]. In addition, we show that with training, subjects' performance improved in terms of time required to accomplish a block of 24 trials despite a decreasing level of visual feedback. The proposed design constitutes a substantial conceptual improvement for the control of multi-functional prosthetic hands. We show for the first time that deep-learning based computer vision systems can enhance the grip functionality of myoelectric hands considerably.

Deep learning-based artificial vision for grasp classification in myoelectric hands

NASA Astrophysics Data System (ADS)

Ghazaei, Ghazal; Alameer, Ali; Degenaar, Patrick; Morgan, Graham; Nazarpour, Kianoush

2017-06-01

Objective. Computer vision-based assistive technology solutions can revolutionise the quality of care for people with sensorimotor disorders. The goal of this work was to enable trans-radial amputees to use a simple, yet efficient, computer vision system to grasp and move common household objects with a two-channel myoelectric prosthetic hand. Approach. We developed a deep learning-based artificial vision system to augment the grasp functionality of a commercial prosthesis. Our main conceptual novelty is that we classify objects with regards to the grasp pattern without explicitly identifying them or measuring their dimensions. A convolutional neural network (CNN) structure was trained with images of over 500 graspable objects. For each object, 72 images, at {{5}\\circ} intervals, were available. Objects were categorised into four grasp classes, namely: pinch, tripod, palmar wrist neutral and palmar wrist pronated. The CNN setting was first tuned and tested offline and then in realtime with objects or object views that were not included in the training set. Main results. The classification accuracy in the offline tests reached 85 % for the seen and 75 % for the novel objects; reflecting the generalisability of grasp classification. We then implemented the proposed framework in realtime on a standard laptop computer and achieved an overall score of 84 % in classifying a set of novel as well as seen but randomly-rotated objects. Finally, the system was tested with two trans-radial amputee volunteers controlling an i-limb UltraTM prosthetic hand and a motion controlTM prosthetic wrist; augmented with a webcam. After training, subjects successfully picked up and moved the target objects with an overall success of up to 88 % . In addition, we show that with training, subjects’ performance improved in terms of time required to accomplish a block of 24 trials despite a decreasing level of visual feedback. Significance. The proposed design constitutes a substantial conceptual improvement for the control of multi-functional prosthetic hands. We show for the first time that deep-learning based computer vision systems can enhance the grip functionality of myoelectric hands considerably.

Accuracy of a Basketball Indoor Tracking System Based on Standard Bluetooth Low Energy Channels (NBN23®).

PubMed

Figueira, Bruno; Gonçalves, Bruno; Folgado, Hugo; Masiulis, Nerijus; Calleja-González, Julio; Sampaio, Jaime

2018-06-14

The present study aims to identify the accuracy of the NBN23 ® system, an indoor tracking system based on radio-frequency and standard Bluetooth Low Energy channels. Twelve capture tags were attached to a custom cart with fixed distances of 0.5, 1.0, 1.5, and 1.8 m. The cart was pushed along a predetermined course following the lines of a standard dimensions Basketball court. The course was performed at low speed (<10.0 km/h), medium speed (>10.0 km/h and <20.0 km/h) and high speed (>20.0 km/h). Root mean square error (RMSE) and percentage of variance accounted for (%VAF) were used as accuracy measures. The obtained data showed acceptable accuracy results for both RMSE and %VAF, despite the expected degree of error in position measurement at higher speeds. The RMSE for all the distances and velocities presented an average absolute error of 0.30 ± 0.13 cm with 90.61 ± 8.34 of %VAF, in line with most available systems, and considered acceptable for indoor sports. The processing of data with filter correction seemed to reduce the noise and promote a lower relative error, increasing the %VAF for each measured distance. Research using positional-derived variables in Basketball is still very scarce; thus, this independent test of the NBN23 ® tracking system provides accuracy details and opens up opportunities to develop new performance indicators that help to optimize training adaptations and performance.

The U.S. Army in the 1970's: Developments in Training and Manpower Technologies. Professional Paper 77-01.

ERIC Educational Resources Information Center

Prophet, Wallace W.

An examination of Army instructional research and training programs in three specific areas may suggest implications for civilian instruction: (1) Performance-based instructional systems, (2) education and training for lower aptitude personnel, and (3) uses of instructional technology. The performance-based instructional system is based on…

Effectiveness of an Evidence-Based Quality Improvement Approach to Cultural Competence Training: The Veterans Affairs' "Caring for Women Veterans" Program.

PubMed

Fox, Annie B; Hamilton, Alison B; Frayne, Susan M; Wiltsey-Stirman, Shannon; Bean-Mayberry, Bevanne; Carney, Diane; Di Leone, Brooke A L; Gierisch, Jennifer M; Goldstein, Karen M; Romodan, Yasmin; Sadler, Anne G; Yano, Elizabeth M; Yee, Ellen F; Vogt, Dawne

2016-01-01

Although providing culturally sensitive health care is vitally important, there is little consensus regarding the most effective strategy for implementing cultural competence trainings in the health care setting. Evidence-based quality improvement (EBQI), which involves adapting evidence-based practices to meet local needs, may improve uptake and effectiveness of a variety of health care innovations. Yet, to our knowledge, EBQI has not yet been applied to cultural competence training. To evaluate whether EBQI could enhance the impact of an evidence-based training intended to improve veterans affairs health care staff gender sensitivity and knowledge (Caring for Women Veterans; CWV), we compared the reach and effectiveness of EBQI delivery versus standard web-based implementation strategies of CWV and assessed barriers and facilitators to EBQI implementation. Workgroups at four diverse veterans affairs health care sites were randomized to either an EBQI or standard web-based implementation condition (SI). All EBQI sites selected a group-based implementation strategy. Employees (N = 84) completed pretraining and posttraining assessments of gender sensitivity and knowledge, and focus groups/interviews were conducted with leadership and staff before and after implementation. Reach of CWV was greater in the EBQI condition versus the SI condition. Whereas both gender sensitivity and knowledge improved in the EBQI condition, only gender sensitivity improved in the SI condition. Qualitative analyses revealed that the EBQI approach was well received, although a number of barriers were identified. Findings suggest that EBQI can enhance the uptake and effectiveness of employee trainings. However, the decision to pursue EBQI must be informed by a consideration of available resources.

Blueprint. Number 1

ERIC Educational Resources Information Center

White, April D., Ed.

2008-01-01

This first issue of "Blueprint" focuses on standards that states have adopted to delineate what students should know at each grade level of the K-12 system. Textbooks, teacher training, professional development, and assessments are built upon education standards. To generate information that will help state leaders improve their…

Suggested Guide for Fire Service Standard Operating Procedures.

ERIC Educational Resources Information Center

Gillett, Merl; Hertzler, Simon L.

Suggested guidelines for the development of fire service standard operating procedures are presented in this document. Section topics are as follow: chain of command; communications; emergency response; apparatus; fire service training; disaster response; aircraft fire safety; mutual aid; national reporting system (example reporting forms);…

Experience with a pharmacy technician medication history program.

PubMed

Cooper, Julie B; Lilliston, Michelle; Brooks, DeAnne; Swords, Bruce

2014-09-15

The implementation and outcomes of a pharmacy technician medication history program are described. An interprofessional medication reconciliation team, led by a clinical pharmacist and a clinical nurse specialist, was charged with implementing a new electronic medication reconciliation system to improve compliance with medication reconciliation at discharge and capture compliance-linked reimbursement. The team recommended that the pharmacy department be allocated new pharmacy technician full-time-equivalent positions to assume ownership of the medication history process. Concurrent with the implementation of this program, a medication history standard was developed to define rules for documentation of what a patient reports he or she is actually taking. The standard requires a structured interview with the patient or caregiver and validation with outside sources as indicated to determine which medications to document in the medication history. The standard is based on four medication administration category rules: scheduled, as-needed, short-term, and discontinued medications. The medication history standard forms the core of the medication history technician training and accountability program. Pharmacy technicians are supervised by pharmacists, using a defined accountability plan based on a set of medical staff approved rules for what medications comprise a best possible medication history. Medication history accuracy and completeness rates have been consistently over 90% and rates of provider compliance with medication reconciliation rose from under 20% to 100% since program implementation. A defined medication history based on a medication history standard served as an effective foundation for a pharmacy technician medication history program, which helped improve provider compliance with discharge medication reconciliation. Copyright © 2014 by the American Society of Health-System Pharmacists, Inc. All rights reserved.

Design of the multicenter standardized supervised exercise training intervention for the claudication: exercise vs endoluminal revascularization (CLEVER) study.

PubMed

Bronas, Ulf G; Hirsch, Alan T; Murphy, Timothy; Badenhop, Dalynn; Collins, Tracie C; Ehrman, Jonathan K; Ershow, Abby G; Lewis, Beth; Treat-Jacobson, Diane J; Walsh, M Eileen; Oldenburg, Niki; Regensteiner, Judith G

2009-11-01

The CLaudication: Exercise Vs Endoluminal Revascularization (CLEVER) study is the first randomized, controlled, clinical, multicenter trial that is evaluating a supervised exercise program compared with revascularization procedures to treat claudication. In this report, the methods and dissemination techniques of the supervised exercise training intervention are described. A total of 217 participants are being recruited and randomized to one of three arms: (1) optimal medical care; (2) aortoiliac revascularization with stent; or (3) supervised exercise training. Of the enrolled patients, 84 will receive supervised exercise therapy. Supervised exercise will be administered according to a protocol designed by a central CLEVER exercise training committee based on validated methods previously used in single center randomized control trials. The protocol will be implemented at each site by an exercise committee member using training methods developed and standardized by the exercise training committee. The exercise training committee reviews progress and compliance with the protocol of each participant weekly. In conclusion, a multicenter approach to disseminate the supervised exercise training technique and to evaluate its efficacy, safety and cost-effectiveness for patients with claudication due to peripheral arterial disease (PAD) is being evaluated for the first time in CLEVER. The CLEVER study will further establish the role of supervised exercise training in the treatment of claudication resulting from PAD and provide standardized methods for use of supervised exercise training in future PAD clinical trials as well as in clinical practice.

Department of National Defence's use of thermography for facilities maintenance

NASA Astrophysics Data System (ADS)

Kittson, John E.

1990-03-01

Since the late seventies DND through the Director General Works has been actively encouraging the use of thermography as an efficient and effective technique for supporting preventive maintenance quality assurance and energy conservation programs at Canadian Forces Bases (CFBs). This paper will provide an overview of DND''s experiences in the utilization of thermography for facilities maintenance applications. 1. HISTORICAL MILESTONES The following are milestones of DND''s use of thermography: a. Purchase of Infrared Equipment In 1976/77 DND purchased five AGA 750 Infrared Thermovision Systems which were distributed to commands. In 1980/81/82 six AGA liOs five AGA TPT8Os two AGA 782s and one AGA 720 were acquired. Finally DND also purchased seven AGEMA 870 systems during 1987/88. b. First and Second Interdepartaental Building Thermography Courses In 1978 and 1980 DND hosted two building thermography courses that were conducted by Public Works Canada. c. CE Thermographer Specialist Training Courses DND developed a training standard in 1983 for Construction Engineering (CE) Thermographer qualification which included all CE applications of thermography. The first annual inhouse training course was conducted at CFB Borden Ontario in 1984. These are now being conducted at the CFB Chilliwack Detachment in Vernon British Columbia. 2 . MARKETING FACILITIES MAINTENANCE IR Of paramount importance for successfully developing DND appreciation for thermography was providing familiarization training to CE staff at commands and bases. These threeday presentations emphasized motivational factors conducting thermographic surveys and utilizing infrared data of roofs electrical/mechanical systems heating plants steam distribution and building enclosures. These factors consisted mainly of the following objectives: a. preventive maintenance by locating deficiencies to be repaired b. quality assurance by verification of workmanship materials and design c. energy conservation by locating heat loss areas 2 / SPIE Vol. 1313 Thermosense XII (1990)

Automatic recognition of falls in gait-slip training: Harness load cell based criteria.

PubMed

Yang, Feng; Pai, Yi-Chung

2011-08-11

Over-head-harness systems, equipped with load cell sensors, are essential to the participants' safety and to the outcome assessment in perturbation training. The purpose of this study was to first develop an automatic outcome recognition criterion among young adults for gait-slip training and then verify such criterion among older adults. Each of 39 young and 71 older subjects, all protected by safety harness, experienced 8 unannounced, repeated slips, while walking on a 7m walkway. Each trial was monitored with a motion capture system, bilateral ground reaction force (GRF), harness force, and video recording. The fall trials were first unambiguously indentified with careful visual inspection of all video records. The recoveries without balance loss (in which subjects' trailing foot landed anteriorly to the slipping foot) were also first fully recognized from motion and GRF analyses. These analyses then set the gold standard for the outcome recognition with load cell measurements. Logistic regression analyses based on young subjects' data revealed that the peak load cell force was the best predictor of falls (with 100% accuracy) at the threshold of 30% body weight. On the other hand, the peak moving average force of load cell across 1s period, was the best predictor (with 100% accuracy) separating recoveries with backward balance loss (in which the recovery step landed posterior to slipping foot) from harness assistance at the threshold of 4.5% body weight. These threshold values were fully verified using the data from older adults (100% accuracy in recognizing falls). Because of the increasing popularity in the perturbation training coupling with the protective over-head-harness system, this new criterion could have far reaching implications in automatic outcome recognition during the movement therapy. Copyright © 2011 Elsevier Ltd. All rights reserved.

A web-based system for neural network based classification in temporomandibular joint osteoarthritis.

PubMed

de Dumast, Priscille; Mirabel, Clément; Cevidanes, Lucia; Ruellas, Antonio; Yatabe, Marilia; Ioshida, Marcos; Ribera, Nina Tubau; Michoud, Loic; Gomes, Liliane; Huang, Chao; Zhu, Hongtu; Muniz, Luciana; Shoukri, Brandon; Paniagua, Beatriz; Styner, Martin; Pieper, Steve; Budin, Francois; Vimort, Jean-Baptiste; Pascal, Laura; Prieto, Juan Carlos

2018-07-01

The purpose of this study is to describe the methodological innovations of a web-based system for storage, integration and computation of biomedical data, using a training imaging dataset to remotely compute a deep neural network classifier of temporomandibular joint osteoarthritis (TMJOA). This study imaging dataset consisted of three-dimensional (3D) surface meshes of mandibular condyles constructed from cone beam computed tomography (CBCT) scans. The training dataset consisted of 259 condyles, 105 from control subjects and 154 from patients with diagnosis of TMJ OA. For the image analysis classification, 34 right and left condyles from 17 patients (39.9 ± 11.7 years), who experienced signs and symptoms of the disease for less than 5 years, were included as the testing dataset. For the integrative statistical model of clinical, biological and imaging markers, the sample consisted of the same 17 test OA subjects and 17 age and sex matched control subjects (39.4 ± 15.4 years), who did not show any sign or symptom of OA. For these 34 subjects, a standardized clinical questionnaire, blood and saliva samples were also collected. The technological methodologies in this study include a deep neural network classifier of 3D condylar morphology (ShapeVariationAnalyzer, SVA), and a flexible web-based system for data storage, computation and integration (DSCI) of high dimensional imaging, clinical, and biological data. The DSCI system trained and tested the neural network, indicating 5 stages of structural degenerative changes in condylar morphology in the TMJ with 91% close agreement between the clinician consensus and the SVA classifier. The DSCI remotely ran with a novel application of a statistical analysis, the Multivariate Functional Shape Data Analysis, that computed high dimensional correlations between shape 3D coordinates, clinical pain levels and levels of biological markers, and then graphically displayed the computation results. The findings of this study demonstrate a comprehensive phenotypic characterization of TMJ health and disease at clinical, imaging and biological levels, using novel flexible and versatile open-source tools for a web-based system that provides advanced shape statistical analysis and a neural network based classification of temporomandibular joint osteoarthritis. Published by Elsevier Ltd.

[Integrated Peer Teaching of Communication and Clinical Skills: How to Train Student Tutors?].

PubMed

Ringel, Nadja; Bürmann, Barbara Maatouk; Fellmer-Drueg, Erika; Roos, Marco; Herzog, Wolfgang; Nikendei, Christoph; Wischmann, Tewes; Weiss, Carmen; Eicher, Christiane; Engeser, Peter; Schultz, Jobst-Hendrik; Jünger, Jana

2015-08-01

This paper describes the theory-based development of a standardized training model for peer tutors. The aim is to qualify tutors to teach communication skills integrated with practical clinical skills, to medical students in the pre-clinical curriculum. As a result, students are encouraged to form a basic understanding of the biopsychosocial model of diseases early in their studies. The training model's design is based on the Kern model for curriculum development as adapted by McLean et al., who outlined the following steps: planning, implementation, and evaluation/feedback. Our focus is on development, review of feasibility, and evaluation as measured by the subjectively perceived effectiveness of the implemented training model. 2 target groups were considered: the peer tutors and the student tutees. In 2009, a 3-step training model consisting of 12 units was developed, based on the theory of patient-centered communication and the biopsychosocial model. The training was rated very positively on a 5-point Likert scale by all tutors at 2 points in time: t1 (directly after training) and t2 (after conducting 2 tutorials) (t1: M=1.67; SD=±0.86; t2: M=1.75; SD=±0.71). On a 6-point Likert scale, the tutees also evaluated their communication and clinical skills as being significantly better after completing the 10 tutorials (t2: scale for interaction and communication: M=4.81; SD: 1.09; scale for clinical examination: M=4.99; SD: 0.85) than before the tutorials (t0: scale for communication and interaction: M=3.18; SD=1.15; scale for clinical examination: M=2.88; SD: 1.09). By implementing a standardized tutor training model, one can qualify peer tutors to teach communication skills integrated with practical clinical skills during the pre-clinical phase. Practice teaching of the curricular material via role playing, tutorial simulation and an extensive feedback session, along with the definition of clinical standards for recording case histories and performing examinations, have proven themselves to be core elements of effective tutor training. © Georg Thieme Verlag KG Stuttgart · New York.

A Review of Twenty Years of Competency-Based Training in the Australian Vocational Education and Training System

ERIC Educational Resources Information Center

Smith, Erica

2010-01-01

In this paper, the author reflects, both as an academic researcher and as a senior practitioner, on the experience of competency-based training (CBT) in the Australian vocational education and training system. She seeks to draw conclusions about the Australian experience using a typology drawn from the academic literature which focuses on the…

[Improvement of team competence in the operating room : Training programs from aviation].

PubMed

Schmidt, C E; Hardt, F; Möller, J; Malchow, B; Schmidt, K; Bauer, M

2010-08-01

Growing attention has been drawn to patient safety during recent months due to media reports of clinical errors. To date only clinical incident reporting systems have been implemented in acute care hospitals as instruments of risk management. However, these systems only have a limited impact on human factors which account for the majority of all errors in medicine. Crew resource management (CRM) starts here. For the commissioning of a new hospital in Minden, training programs were installed in order to maintain patient safety in a new complex environment. The training was planned in three parts: All relevant processes were defined as standard operating procedures (SOP), visualized and then simulated in the new building. In addition, staff members (trainers) in leading positions were trained in CRM in order to train the complete staff. The training programs were analyzed by questionnaires. Selection of topics, relevance for practice and mode of presentation were rated as very good by 73% of the participants. The staff members ranked the topics communication in crisis situations, individual errors and compensating measures as most important followed by case studies and teamwork. Employees improved in compliance to the SOP, team competence and communication. In high technology environments with escalating workloads and interdisciplinary organization, staff members are confronted with increasing demands in knowledge and skills. To reduce errors under such working conditions relevant processes should be standardized and trained for the emergency situation. Human performance can be supported by well-trained interpersonal skills which are evolved in CRM training. In combination these training programs make a significant contribution to maintaining patient safety.

Training set optimization and classifier performance in a top-down diabetic retinopathy screening system

NASA Astrophysics Data System (ADS)

Wigdahl, J.; Agurto, C.; Murray, V.; Barriga, S.; Soliz, P.

2013-03-01

Diabetic retinopathy (DR) affects more than 4.4 million Americans age 40 and over. Automatic screening for DR has shown to be an efficient and cost-effective way to lower the burden on the healthcare system, by triaging diabetic patients and ensuring timely care for those presenting with DR. Several supervised algorithms have been developed to detect pathologies related to DR, but little work has been done in determining the size of the training set that optimizes an algorithm's performance. In this paper we analyze the effect of the training sample size on the performance of a top-down DR screening algorithm for different types of statistical classifiers. Results are based on partial least squares (PLS), support vector machines (SVM), k-nearest neighbor (kNN), and Naïve Bayes classifiers. Our dataset consisted of digital retinal images collected from a total of 745 cases (595 controls, 150 with DR). We varied the number of normal controls in the training set, while keeping the number of DR samples constant, and repeated the procedure 10 times using randomized training sets to avoid bias. Results show increasing performance in terms of area under the ROC curve (AUC) when the number of DR subjects in the training set increased, with similar trends for each of the classifiers. Of these, PLS and k-NN had the highest average AUC. Lower standard deviation and a flattening of the AUC curve gives evidence that there is a limit to the learning ability of the classifiers and an optimal number of cases to train on.

The Surgical Simulation and Training Markup Language (SSTML): an XML-based language for medical simulation.

PubMed

Bacon, James; Tardella, Neil; Pratt, Janey; Hu, John; English, James

2006-01-01

Under contract with the Telemedicine & Advanced Technology Research Center (TATRC), Energid Technologies is developing a new XML-based language for describing surgical training exercises, the Surgical Simulation and Training Markup Language (SSTML). SSTML must represent everything from organ models (including tissue properties) to surgical procedures. SSTML is an open language (i.e., freely downloadable) that defines surgical training data through an XML schema. This article focuses on the data representation of the surgical procedures and organ modeling, as they highlight the need for a standard language and illustrate the features of SSTML. Integration of SSTML with software is also discussed.

75 FR 17911 - Privacy Act of 1974; System of Records

Federal Register 2010, 2011, 2012, 2013, 2014

2010-04-08

...) (June 11, 1997; 62 FR 31793). Reason: The 1550th Technical Training Squadron, Kirtland Air Force Base...: The 1550th Combat Crew Training Wing, Kirtland Air Force Base, NM, no longer exists. Training now..., Kirtland Air Force Base, NM, no longer exists. Training now falls under the Air Education Training Command...

75 FR 2597 - Positive Train Control Systems

Federal Register 2010, 2011, 2012, 2013, 2014

2010-01-15

... requirements for PTC system standard design and functionality, the associated submissions for FRA PTC system..., notwithstanding enforcement of railroad operating rules designed to prevent them. As early as 1970, following its... workers continued as a result of the absence of effective enforcement systems designed to compensate for...

A radiation-free mixed-reality training environment and assessment concept for C-arm-based surgery.

PubMed

Stefan, Philipp; Habert, Séverine; Winkler, Alexander; Lazarovici, Marc; Fürmetz, Julian; Eck, Ulrich; Navab, Nassir

2018-06-25

The discrepancy of continuously decreasing opportunities for clinical training and assessment and the increasing complexity of interventions in surgery has led to the development of different training and assessment options like anatomical models, computer-based simulators or cadaver trainings. However, trainees, following training, assessment and ultimately performing patient treatment, still face a steep learning curve. To address this problem for C-arm-based surgery, we introduce a realistic radiation-free simulation system that combines patient-based 3D printed anatomy and simulated X-ray imaging using a physical C-arm. To explore the fidelity and usefulness of the proposed mixed-reality system for training and assessment, we conducted a user study with six surgical experts performing a facet joint injection on the simulator. In a technical evaluation, we show that our system simulates X-ray images accurately with an RMSE of 1.85 mm compared to real X-ray imaging. The participants expressed agreement with the overall realism of the simulation, the usefulness of the system for assessment and strong agreement with the usefulness of such a mixed-reality system for training of novices and experts. In a quantitative analysis, we furthermore evaluated the suitability of the system for the assessment of surgical skills and gather preliminary evidence for validity. The proposed mixed-reality simulation system facilitates a transition to C-arm-based surgery and has the potential to complement or even replace large parts of cadaver training, to provide a safe assessment environment and to reduce the risk for errors when proceeding to patient treatment. We propose an assessment concept and outline the steps necessary to expand the system into a test instrument that provides reliable and justified assessments scores indicative of surgical proficiency with sufficient evidence for validity.

Oregon Indigenous Farmworkers: Results of Promotor Intervention on Pesticide Knowledge and Organophosphate Metabolite Levels

PubMed Central

McCauley, Linda; Runkle, Jennifer D.; Samples, Julie; Williams, Bryan; Muniz, Juan F; Semple, Marie; Shadbeh, Nargess

2013-01-01

Objectives Examine changes in health beliefs, pesticide safety knowledge, and biomarkers of pesticide exposure in indigenous farmworker who received enhanced pesticide safety training compared to those receiving the standard training. Methods Farmworkers in Oregon were randomly assigned to either a promotores pesticide safety training program or a standard video-based training. Spot urine samples were analyzed for dialkylphosphate (DAP) urinary metabolites. Pre/post intervention questionnaires were used to measure pesticide safety knowledge, health beliefs and work practices. Results Baseline to follow-up improvements in total pesticide knowledge scores were higher in the promotor group compared to the video. Pairwise differences in mean concentrations of DAP metabolite levels showed declines from baseline to follow-up for both intervention groups. Conclusions Results showed reductions in pesticide exposure in indigenous-language speaking farmworkers who receive enhanced pesticide safety training. PMID:24064776

Effect of mobile application-based versus DVD-based CPR training on students’ practical CPR skills and willingness to act: a cluster randomised study

PubMed Central

Nord, Anette; Svensson, Leif; Hult, Håkan; Kreitz-Sandberg, Susanne; Nilsson, Lennart

2016-01-01

Objectives The aim was to compare students’ practical cardiopulmonary resuscitation (CPR) skills and willingness to perform bystander CPR, after a 30 min mobile application (app)-based versus a 50 min DVD-based training. Settings Seventh grade students in two Swedish municipalities. Design A cluster randomised trial. The classes were randomised to receive app-based or DVD-based training. Willingness to act and practical CPR skills were assessed, directly after training and at 6 months, by using a questionnaire and a PC Skill Reporting System. Data on CPR skills were registered in a modified version of the Cardiff test, where scores were given in 12 different categories, adding up to a total score of 12–48 points. Training and measurements were performed from December 2013 to October 2014. Participants 63 classes or 1232 seventh grade students (13-year-old) were included in the study. Primary and secondary outcome measures Primary end point was the total score of the modified Cardiff test. The individual variables of the test and self-reported willingness to make a life-saving intervention were secondary end points. Results The DVD-based group was superior to the app-based group in CPR skills; a total score of 36 (33–38) vs 33 (30–36) directly after training (p<0.001) and 33 (30–36) and 31 (28–34) at 6 months (p<0.001), respectively. At 6 months, the DVD group performed significantly better in 8 out of 12 CPR skill components. Both groups improved compression depth from baseline to follow-up. If a friend suffered cardiac arrest, 78% (DVD) versus 75% (app) would do compressions and ventilations, whereas only 31% (DVD) versus 32% (app) would perform standard CPR if the victim was a stranger. Conclusions At 6 months follow-up, the 50 min DVD-based group showed superior CPR skills compared with the 30 min app-based group. The groups did not differ in regard to willingness to make a life-saving effort. PMID:27130166

Decaying Relevance of Clinical Data Towards Future Decisions in Data-Driven Inpatient Clinical Order Sets

PubMed Central

Chen, Jonathan H; Alagappan, Muthuraman; Goldstein, Mary K; Asch, Steven M; Altman, Russ B

2017-01-01

Objective Determine how varying longitudinal historical training data can impact prediction of future clinical decisions. Estimate the “decay rate” of clinical data source relevance. Materials and Methods We trained a clinical order recommender system, analogous to Netflix or Amazon’s “Customers who bought A also bought B…” product recommenders, based on a tertiary academic hospital’s structured electronic health record data. We used this system to predict future (2013) admission orders based on different subsets of historical training data (2009 through 2012), relative to existing human-authored order sets. Results Predicting future (2013) inpatient orders is more accurate with models trained on just one month of recent (2012) data than with 12 months of older (2009) data (ROC AUC 0.91 vs. 0.88, precision 27% vs. 22%, recall 52% vs. 43%, all P<10−10). Algorithmically learned models from even the older (2009) data was still more effective than existing human-authored order sets (ROC AUC 0.81, precision 16% recall 35%). Training with more longitudinal data (2009–2012) was no better than using only the most recent (2012) data, unless applying a decaying weighting scheme with a “half-life” of data relevance about 4 months. Discussion Clinical practice patterns (automatically) learned from electronic health record data can vary substantially across years. Gold standards for clinical decision support are elusive moving targets, reinforcing the need for automated methods that can adapt to evolving information. Conclusions and Relevance Prioritizing small amounts of recent data is more effective than using larger amounts of older data towards future clinical predictions. PMID:28495350

Observer Use of Standardized Observation Protocols in Consequential Observation Systems

ERIC Educational Resources Information Center

Bell, Courtney A.; Yi, Qi; Jones, Nathan D.; Lewis, Jennifer M.; McLeod, Monica; Liu, Shuangshuang

2014-01-01

Evidence from a handful of large-scale studies suggests that although observers can be trained to score reliably using observation protocols, there are concerns related to initial training and calibration activities designed to keep observers scoring accurately over time (e.g., Bell, et al, 2012; BMGF, 2012). Studies offer little insight into how…

Guidelines for Biosafety Training Programs for Workers Assigned to BSL-3 Research Laboratories.

PubMed

Homer, Lesley C; Alderman, T Scott; Blair, Heather Ann; Brocard, Anne-Sophie; Broussard, Elaine E; Ellis, Robert P; Frerotte, Jay; Low, Eleanor W; McCarthy, Travis R; McCormick, Jessica M; Newton, JeT'Aime M; Rogers, Francine C; Schlimgen, Ryan; Stabenow, Jennifer M; Stedman, Diann; Warfield, Cheryl; Ntiforo, Corrie A; Whetstone, Carol T; Zimmerman, Domenica; Barkley, Emmett

2013-03-01

The Guidelines for Biosafety Training Programs for Workers Assigned to BSL-3 Research Laboratories were developed by biosafety professionals who oversee training programs for the 2 national biocontainment laboratories (NBLs) and the 13 regional biocontainment laboratories (RBLs) that participate in the National Institute of Allergy and Infectious Diseases (NIAID) NBL/RBL Network. These guidelines provide a general training framework for biosafety level 3 (BSL-3) high-containment laboratories, identify key training concepts, and outline training methodologies designed to standardize base knowledge, understanding, and technical competence of laboratory personnel working in high-containment laboratories. Emphasis is placed on building a culture of risk assessment-based safety through competency training designed to enhance understanding and recognition of potential biological hazards as well as methods for controlling these hazards. These guidelines may be of value to other institutions and academic research laboratories that are developing biosafety training programs for BSL-3 research.